Jennifer Ranallo, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22596 Issued in MN

Practice address

9600 Upland LN N Ste 110
Maple Grove, MN 55369

Phone

(952) 993-6200

NPI assigned

Nov 13, 2016

Sex

Female

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

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.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1478995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1750823324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 UPLAND LN N STE 110",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694499",
            "telephone_number": "952-993-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 UPLAND LN N STE 110",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "952-993-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5165 71st Ln",
            "address_purpose": "LOCATION",
            "city": "Loretto",
            "state": "MN",
            "postal_code": "553579581",
            "country_code": "US",
            "telephone_number": "612-423-5321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5165 71st Ln",
            "address_purpose": "LOCATION",
            "city": "Loretto",
            "state": "MN",
            "postal_code": "553579581",
            "country_code": "US",
            "telephone_number": "612-423-5321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANALLO",
        "first_name": "JENNIFER",
        "credential": "MSW,  LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-13",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sneha Madhwa Raj, PSY.D
• Archana Ramaswamy, MD
• Shivnarine Ramdeo, PMHNP
• Debra Grace Ramesh, CNM/WHNP
• Matthew R Ramsey, M.D.
• Angelily Jo Rasivong
• Stacy Rask, RM
• Matthew T Rasmussen, MD
• Cristal Mae Ratliff
• RBF LLC

• Clinical Social Worker in Maple Grove, MN
• Providers in Maple Grove, 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 Oct 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.