Ruben Meza Maldonado Jr., LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

31341 Issued in MN

Practice address

562 Bavaria LN
Chaska, MN 55318-4597

Phone

(612) 208-9355

NPI assigned

Aug 8, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1628380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1932873395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 KYLE AVE N",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554223632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 BAVARIA LN",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553184597",
            "telephone_number": "612-208-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEZA MALDONADO JR.",
        "first_name": "RUBEN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-08",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "31341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Dillon McMahon, D.D.S. M.S.
• Josephine Melek
• Thomas John Meschke, DDS
• Metropolitan Anesthesia Consultants, LLC
• Ethan Meyer
• Allison Midwinter, MSW, LICSW
• Vicki Jane Miles, P.T.
• Danielle Adair Miller
• Sara Miller, LPCC
• William Miller, M.D.

• Clinical Social Worker in Chaska, MN
• Providers in Chaska, 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 Sep 12, 2024; 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.