Healthcare Provider Details

I. General information

NPI: 1215831805
Provider Name (Legal Business Name): HYLAN REEL MCLAUGHLIN LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 GALLAGHER DR APT 316
EDINA MN
55435-3156
US

IV. Provider business mailing address

7320 GALLAGHER DR APT 316
EDINA MN
55435-3156
US

V. Phone/Fax

Practice location:
  • Phone: 406-369-5200
  • Fax:
Mailing address:
  • Phone: 406-369-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29064
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: