Noureen Mehreen Wallani, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20167 Issued in MN

Practice address

6425 Nicollet Ave
Richfield, MN 55423-1675

Phone

(612) 861-1675

Fax

(612) 861-3446

NPI assigned

Sep 6, 2013

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1780019935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6425 NICOLLET AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231675",
            "telephone_number": "612-861-1675",
            "fax_number": "612-861-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 NICOLLET AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231675",
            "telephone_number": "612-861-1675",
            "fax_number": "612-861-3446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Highway 7 Ste 309",
            "address_purpose": "LOCATION",
            "city": "Hopkins",
            "state": "MN",
            "postal_code": "553054737",
            "country_code": "US",
            "telephone_number": "952-426-6601",
            "fax_number": "952-938-4708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5910 Shingle Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Center",
            "state": "MN",
            "postal_code": "554302322",
            "country_code": "US",
            "telephone_number": "763-569-5200",
            "fax_number": "763-569-5201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLANI",
        "first_name": "NOUREEN",
        "middle_name": "MEHREEN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-06",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Richfield, MN
• Providers in Richfield, 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 Mar 20, 2023; 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.