Individual provider Active NPI

Marya Dumke, LICSW MSW

  • Clinical Social Worker
  • Golden Valley, MN
National Provider Identifier
1700673894
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24654 Issued in MN
Practice address
6501 Olson Memorial Hwy
Golden Valley, MN 55427-4948
Phone
(952) 374-9984
NPI assigned
Apr 22, 2025
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 24654 MN Primary

Addresses

Primary practice location

6501 Olson Memorial Hwy
Golden Valley, MN 55427-4948

Mailing address

6501 Olson Memorial Hwy
Golden Valley, MN 55427-4948
Phone (952) 374-9984

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

LicenseStateTypeSpecialty
24654MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1700673894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 OLSON MEMORIAL HWY",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274948",
            "telephone_number": "952-374-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 OLSON MEMORIAL HWY",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274948",
            "telephone_number": "952-374-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMKE",
        "first_name": "MARYA",
        "credential": "LICSW MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.