Individual provider Active NPI

Jennifer McVay, L.I.C.S.W.

  • Clinical Social Worker
  • Bloomington, MN
National Provider Identifier
1962484014
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15431 Issued in MN
Practice address
7800 Metro Pkwy
Suite 300
Bloomington, MN 55425-1514
Phone
(952) 854-4377
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 15431 MN Primary

Addresses

Primary practice location

7800 Metro Pkwy
Suite 300
Bloomington, MN 55425-1514

Mailing address

4290 Sunrise Rd
Eagan, MN 55122-2249
Phone (612) 508-8715

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
15431MNMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247616000000",
    "number": "1962484014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 SUNRISE RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222249",
            "telephone_number": "612-508-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 METRO PKWY",
            "address_2": "SUITE 300",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251514",
            "telephone_number": "952-854-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCVAY",
        "first_name": "JENNIFER",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2009-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; 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.