Active NPI
Shukri A Mohamed, LICSW
- Clinical Social Worker
- Minneapolis, MN
National Provider Identifier
1710835434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 29561
- Practice address
- 617 Cedar Ave S # 165
Minneapolis, MN 55454-7501 - Phone
- (612) 607-4179
- NPI assigned
- Mar 18, 2026
- Sex
- Female
- 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 | 29561 | MN | Primary |
Addresses
Primary practice location
617 Cedar Ave S # 165
Minneapolis, MN 55454-7501
Mailing address
617 Cedar Ave S # 165
Minneapolis, MN 55454-7501
Phone (612) 607-4179
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 |
|---|---|---|---|
| 29561 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773792000000",
"number": "1710835434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "617 CEDAR AVE S # 165",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554547501",
"telephone_number": "612-607-4179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "617 CEDAR AVE S # 165",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554547501",
"telephone_number": "612-607-4179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHAMED",
"first_name": "SHUKRI",
"middle_name": "A",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-03-18",
"last_updated": "2026-03-18",
"certification_date": "2026-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "29561",
"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 Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.