Individual provider Active NPI

Michelle Denise Stronach, MSW

  • Clinical Social Worker
  • Duluth, MN
National Provider Identifier
1669670766
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1889 Issued in MN
Practice address
2002 London Road
Suite 93B
Duluth, MN 55812-2150
Phone
(715) 817-2279
Fax
(715) 394-9182
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1914-123 WI
Clinical Social Worker 1041C0700X 1889 MN Primary

Addresses

Primary practice location

2002 London Road
Suite 93B
Duluth, MN 55812-2150

Mailing address

2002 London Road
Suite 93B
Duluth, MN 55812-2150
Phone (715) 817-2279

Other identifiers 1

IdentifierTypeStateIssuer
39254900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1914-123WIMDClinical Social Worker
1889MNMDOptometrist
1914WIMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1669670766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 LONDON ROAD",
            "address_2": "SUITE 93B",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558122150",
            "telephone_number": "715-817-2279",
            "fax_number": "715-834-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 LONDON ROAD",
            "address_2": "SUITE 93B",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558122150",
            "telephone_number": "715-817-2279",
            "fax_number": "715-394-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRONACH",
        "first_name": "MICHELLE",
        "middle_name": "DENISE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1914-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "1889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39254900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.