MEDICARE: MICHAEL F MCGRANE MSW LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	820298200	OTHER	MN	MEDICAL ASSISTANCE

General Provider Information

NPI Number	:	1033284815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL F MCGRANE MSW LICSW

Provider Business Mailing Address
First Line	:	22797 MEADOWBROOK AVE N
Second Line	:
City	:	SCANDIA
State	:	MN
Zip	:	55073-9429
Country	:	US
Telephone Number	:	651-491-9953
Fax Number	:

Provider Business Practice Location Address
First Line	:	22797 MEADOWBROOK AVE N
Second Line	:
City	:	SCANDIA
State	:	MN
Zip	:	55073-9429
Country	:	US
Telephone Number	:	651-491-9953
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	03/13/2013

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