Individual provider Active NPI

Alexander Joseph McLeod, MSW, LICSW

  • Clinical Social Worker
  • Eden Prairie, MN
National Provider Identifier
1710751003
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
30134 Issued in MN
Practice address
800 Prairie Center Dr
Eden Prairie, MN 55344-7328
Phone
(952) 234-9210
Fax
(952) 234-3933
NPI assigned
Nov 8, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 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 30134 MN Primary

Addresses

Primary practice location

800 Prairie Center Dr
Eden Prairie, MN 55344-7328

Mailing address

800 Prairie Center Dr
Eden Prairie, MN 55344-7328
Phone (952) 234-9210

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
I20240105002915 MN Practitioner - Clinical Social Worker 4789035510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30134MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eden Therapy Center, LLC CurrentSince Dec 1, 2023 Accepting new patients
McLeod Psychotherapy LLC Current Accepting new patients
Dr Brecke Counseling Group Past Accepting new patients

Organizations & group practices 3

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": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1710751003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 PRAIRIE CENTER DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447328",
            "telephone_number": "952-234-9210",
            "fax_number": "952-234-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRAIRIE CENTER DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447328",
            "telephone_number": "952-234-9210",
            "fax_number": "952-234-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "ALEXANDER",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "30134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.