Dawn Diana Draayer-Thibodeau, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15185 Issued in MN

Practice address

4500 Park Glen Rd Ste 155
St Louis Park, MN 55416-4888

Phone

(952) 334-1213

Fax

(952) 928-9774

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

Yes

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

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

University of Iowa, RJ & L Carver College of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dawn Draayer-Thibodeau, LLC

  • Clinical Social Worker
  • St Louis Park, MN
  • NPI 1235524521
  Medicare reassignment NPD Authorized official
• The Lake Group LLC

  • Psychologist
  • St. Louis Park, MN
  • NPI 1346471232

  Clinical

  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972672087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12848 INDEPENDENCE AVE",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553781189",
            "telephone_number": "952-334-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARK GLEN RD STE 155",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164888",
            "telephone_number": "952-334-1213",
            "fax_number": "952-928-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAAYER-THIBODEAU",
        "first_name": "DAWN",
        "middle_name": "DIANA",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78612312-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Levi Stanford Downs, M.D.
• Kristina Ann Doyle, M.S., CCC-SLP
• Dr. Andrea K Ruby DMD PLLC
• Dr. Bruce E. Brandsness P.a.
• Dr. Sheila Fahey LTD.
• Kristine Dragon
• Kevin Criston Drake, DC
• Catherine M Dremel, MD
• Angela A Drew, PT
• Molly Andrea Beebe Drew, JD, MSW, LICSW

• Clinical Social Worker in St Louis Park, MN
• Providers in St Louis Park, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.