Individual provider Active NPI

Tonya Danielle Allen, MSW, LICSW

  • Clinical Social Worker
  • Brooklyn Park, MN
National Provider Identifier
1710750393
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14632 Issued in MN
Practice address
8525 Edinbrook Xing Ste 15
Brooklyn Park, MN 55443-1967
Phone
(763) 691-9002
Fax
(763) 226-2390
NPI assigned
Nov 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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 14632 MN Primary

Addresses

Primary practice location

8525 Edinbrook Xing Ste 15
Brooklyn Park, MN 55443-1967

Mailing address

9121 Victoria CT
Brooklyn Park, MN 55443-1658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241212002920 MN Practitioner - Clinical Social Worker 6608302708 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis Family Wellness Center LLC CurrentSince Dec 9, 2024 Accepting new patients

Locations

3300 4th Ave
Bldg 14
Anoka, MN 55303
Phone (763) 691-9002

8823 Zealand Ave N
Ste H
Brooklyn Park, MN 55445
Phone (202) 880-2812

8525 Edinbrook Xing
Ste 15
Minneapolis, MN 55443
Phone (763) 691-9002

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1710750393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9121 VICTORIA CT",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8525 EDINBROOK XING STE 15",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431967",
            "telephone_number": "763-691-9002",
            "fax_number": "763-226-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "TONYA",
        "middle_name": "DANIELLE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "14632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

Verify at the official NPI Registry.