Active NPI
Meng Vang, LICSW
- Clinical Social Worker
- Eden Prairie, MN
National Provider Identifier
1689085946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 18256
- Practice address
- 11010 Prairie Lakes Dr
350
Eden Prairie, MN 55344-3884 - Phone
- (952) 746-2522
- Fax
- (952) 746-0887
- NPI assigned
- May 8, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 18256 | MN | Primary |
Addresses
Primary practice location
11010 Prairie Lakes Dr
350
Eden Prairie, MN 55344-3884
Mailing address
1900 Silver Lake Rd NW
110
New Brighton, MN 55112-1786
Phone (651) 379-1718
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18256 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423008000000",
"number": "1689085946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 SILVER LAKE RD NW",
"address_2": "110",
"city": "NEW BRIGHTON",
"state": "MN",
"postal_code": "551121786",
"telephone_number": "651-379-1718",
"fax_number": "651-379-1738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11010 PRAIRIE LAKES DR",
"address_2": "350",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553443884",
"telephone_number": "952-746-2522",
"fax_number": "952-746-0887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANG",
"first_name": "MENG",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-08",
"last_updated": "2015-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "18256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.