Basic Information
| Provider Information | |||||||||
| NPI: | 1043443500 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MACDONALD-SEXTON | ||||||||
| FirstName: | CLARE | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | LICSW | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | MACDONALD | ||||||||
| OtherFirstName: | CLARE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8170 33RD AVE S | ||||||||
| Address2: | MS 21110Q | ||||||||
| City: | BLOOMINGTON | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55440 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1885 PLAZA DR | ||||||||
| Address2: | |||||||||
| City: | EAGAN | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551222979 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529934001 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2009 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 13519 | MN | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.