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NPI Code Detail

MEDICARE: MS. MARGARET A SHOEMAKER LICSW IN MINNESOTA

MEDICARE: MS. MARGARET A SHOEMAKER LICSW IN MINNESOTA
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
11041C0700XClinical Social Worker6715-123WI
21041C0700XClinical Social Worker5539MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104016815
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARGARET A SHOEMAKER LICSW IN MINNESOTA
Provider Business Mailing Address
First Line : 1100 GLENWOOD AVE
Second Line : WASHBURN CENTER FOR CHILDREN
City : MINNEAPOLIS
State : MN
Zip : 55405-1430
Country : US
Telephone Number : 612-871-1454
Fax Number : 612-871-1505
Provider Business Practice Location Address
First Line : 1100 GLENWOOD AVE
Second Line : WASHBURN CENTER FOR CHILDREN
City : MINNEAPOLIS
State : MN
Zip : 55405-1430
Country : US
Telephone Number : 612-871-1454
Fax Number : 612-871-1505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2007
Last Update Date : 12/10/2014

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Directions to “ MS. MARGARET A SHOEMAKER LICSW IN MINNESOTA” Practice Location

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