Individual provider Active NPI

Doreen Lorraine Holding Eagle, MSW

  • Clinical Social Worker
  • Ogema, MN
National Provider Identifier
1831488832
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15758 Issued in MN
Practice address
40520 County Highway 34
Ogema, MN 56569-9612
Phone
(218) 983-4300
Fax
(218) 983-6336
NPI assigned
Mar 31, 2011
Last updated
Mar 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 15758 MN Primary
Clinical Social Worker 1041C0700X 4213 ND

Addresses

Primary practice location

40520 County Highway 34
Ogema, MN 56569-9612

Mailing address

40520 County Highway 34
Ogema, MN 56569-9612
Phone (218) 983-4300

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15758MNMDClinical Social Worker
4213NDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1831488832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40520 COUNTY HIGHWAY 34",
            "city": "OGEMA",
            "state": "MN",
            "postal_code": "565699612",
            "telephone_number": "218-983-4300",
            "fax_number": "218-983-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40520 COUNTY HIGHWAY 34",
            "city": "OGEMA",
            "state": "MN",
            "postal_code": "565699612",
            "telephone_number": "218-983-4300",
            "fax_number": "218-983-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDING EAGLE",
        "first_name": "DOREEN",
        "middle_name": "LORRAINE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15758",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "4213",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogema, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; 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.