Michael Hall, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17023 Issued in FM

Practice address

2127 County Road D E Ste A100
Maplewood, MN 55109-5350

Phone

(651) 592-1592

Fax

(651) 429-2988

NPI assigned

May 4, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clayton D. Sankey Licsw, LLC

  • Clinical Social Worker
  • Maplewood, MN
  • NPI 1023097185
  NPD (past)

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1942528740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2127 COUNTY ROAD D E STE A100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095350",
            "telephone_number": "651-592-1592",
            "fax_number": "651-429-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2127 COUNTY ROAD D E STE A100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095350",
            "telephone_number": "651-592-1592",
            "fax_number": "651-429-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-04",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FM",
            "license": "17023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942528740",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dominic Jamil Haddad, DO
• John Haddad
• Bruce C Haglund, DDS
• Heather Hall, MSW, LGSW
• Kathryn Naomi Hall, L.P.
• Daniel Hallbeck
• Marcy Beth Jensen Halvorson, PHD
• Hands Care LLP
• Alison R Hanlin, OTRL
• Abdirahim Hanshi

• Clinical Social Worker in Maplewood, MN
• Providers in Maplewood, 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 Apr 9, 2018; 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.