Individual provider Active NPI

Daniel Edward Lontkowski, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1700914736
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
04985 Issued in MN
Practice address
301 4TH Ave S
Suite 780N
Minneapolis, MN 55415-1015
Phone
(612) 596-6584
Fax
(612) 317-6180
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 04985 MN Primary

Addresses

Primary practice location

301 4TH Ave S
Suite 780N
Minneapolis, MN 55415-1015

Mailing address

301 4TH Ave S
Suite 780N
Minneapolis, MN 55415-1015
Phone (612) 596-6584

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
04985MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1700914736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 4TH AVE S",
            "address_2": "SUITE 780N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151015",
            "telephone_number": "612-596-6584",
            "fax_number": "612-317-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 4TH AVE S",
            "address_2": "SUITE 780N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151015",
            "telephone_number": "612-596-6584",
            "fax_number": "612-317-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONTKOWSKI",
        "first_name": "DANIEL",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "04985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.