Active NPI
Marsha McDonald, MSW, Licsw, LLC
- Clinical Social Worker
- Edina, MN
National Provider Identifier
1992810303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 14892
- Legal business name
- MARSHA MCDONALD, MSW, LICSW, LLC
- Practice address
- 4005 W 65TH St
122
Edina, MN 55435-1720 - Phone
- (952) 285-2917
- NPI assigned
- Aug 19, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Marsha Bernadette McDonald, MSW, LICSW
- Title
- Chief Manager, Treasurer and Secret
- Phone
- (952) 285-2917
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 14892 | MN | Primary |
Addresses
Primary practice location
4005 W 65TH St
122
Edina, MN 55435-1720
Mailing address
4005 W 65TH St
122
Edina, MN 55435-1720
Phone (952) 285-2917
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 258P4MC | Other | MN | BLUECROSS BLUE SHIELD |
| 6271149 | Other | MN | MEDICA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Edina, MN
- NPI 1972616753
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1992810303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4005 W 65TH ST",
"address_2": "122",
"city": "EDINA",
"state": "MN",
"postal_code": "554351720",
"telephone_number": "952-285-2917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4005 W 65TH ST",
"address_2": "122",
"city": "EDINA",
"state": "MN",
"postal_code": "554351720",
"telephone_number": "952-285-2917"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARSHA MCDONALD, MSW, LICSW, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-19",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MCDONALD",
"authorized_official_first_name": "MARSHA",
"authorized_official_middle_name": "BERNADETTE",
"authorized_official_title_or_position": "CHIEF MANAGER, TREASURER AND SECRET",
"authorized_official_telephone_number": "952-285-2917",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "MSW, LICSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "14892",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUE SHIELD",
"identifier": "258P4MC",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6271149",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.