Active NPI
Marnette Rene Doyle, MSW, LICSW
- Clinical Social Worker
- Minneapolis, MN
National Provider Identifier
1760607402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 13551
- Practice address
- 1409 Willow St
Suite 201
Minneapolis, MN 55403-2269 - Phone
- (612) 819-5171
- NPI assigned
- Apr 16, 2007
- 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 | 13551 | MN | Primary |
Addresses
Primary practice location
1409 Willow St
Suite 201
Minneapolis, MN 55403-2269
Mailing address
2710 Sheridan Ave N
Minneapolis, MN 55411-1021
Phone (612) 819-5171
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62-77343 | Other | MN | MEDICA |
| 268K1DO | Other | MN | BLUE CROSS BLUESHIELD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13551 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760607402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2710 SHERIDAN AVE N",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554111021",
"telephone_number": "612-819-5171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 WILLOW ST",
"address_2": "SUITE 201",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554032269",
"telephone_number": "612-819-5171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOYLE",
"first_name": "MARNETTE",
"middle_name": "RENE",
"name_prefix": "Ms.",
"credential": "MSW, LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "13551",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "62-77343",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUESHIELD",
"identifier": "268K1DO",
"state": "MN"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.