Active NPI
Terri Lynn Delaney, LICSW
- Clinical Social Worker
- St Louis Park, MN
National Provider Identifier
1780987701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 19283
- Practice address
- 5407 Excelsior Blvd
Suite B
St Louis Park, MN 55416-2929 - Phone
- (612) 387-4202
- Fax
- (952) 920-9323
- NPI assigned
- Dec 13, 2010
- 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 | 19283 | MN | Primary |
Addresses
Primary practice location
5407 Excelsior Blvd
Suite B
St Louis Park, MN 55416-2929
Mailing address
5407 Excelsior Blvd
Suite B
St Louis Park, MN 55416-2929
Phone (612) 387-4202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 15, 2024 through Dec 15, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19283 | MN | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292198400000",
"number": "1780987701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5407 EXCELSIOR BLVD",
"address_2": "SUITE B",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554162929",
"telephone_number": "612-387-4202",
"fax_number": "952-920-9323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5407 EXCELSIOR BLVD",
"address_2": "SUITE B",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554162929",
"telephone_number": "612-387-4202",
"fax_number": "952-920-9323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELANEY",
"first_name": "TERRI",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-13",
"last_updated": "2010-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "19283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.