Brendan C Shane, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13192 Issued in MN

Practice address

7575 Golden Valley Rd
Golden Valley, MN 55427-4562

Phone

(952) 334-9390

NPI assigned

Jan 30, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Brendan Shane

  • Clinical Social Worker
  • Golden Valley, MN
  • NPI 1366840324
  NPD (past) Authorized official
• Old Towne Wellness, LLC

  • Psychiatry Physician
  • Mechanicsville, VA
  • NPI 1891267761
  NPD (past)

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1720326440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6513 CREEK DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554391207",
            "telephone_number": "952-983-0216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274562",
            "telephone_number": "952-334-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANE",
        "first_name": "BRENDAN",
        "middle_name": "C",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-30",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosalie Irene Seevers, PTA
• Sequence Health LLC
• Serenity Wellness Center LLC
• Steven Severson, LICSW
• Constance S Shaffer, OTR L
• Shansa Care S.C.
• Megan Elizabeth Shaw, LMFT, LADC
• Jerelyn K Sheehan, PT
• Rukiya Ali Sheikh-Mohamed
• Samantha Elizabeth Taleff Shepherd, LICSW

• Clinical Social Worker in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.