MRS. DAWN DIANA DRAAYER-THIBODEAU LICSW NPI 1972672087

NPI Information

  • NPI: 1972672087
  • Provider Name: MRS. DAWN DIANA DRAAYER-THIBODEAU, LICSW
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4500 PARK GLEN RD STE 155
    ST LOUIS PARK, MN
    ZIP 55416
  • Phone: (952) 334-1213

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NPI Details

MRS. Dawn Diana Draayer-thibodeau, LICSW is a clinical social worker in St Louis Park, MN with 27 years of experience. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. MRS. Dawn Diana Draayer-thibodeau, LICSW NPI is 1972672087. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Graduation Year:1998

The provider's business location address is:

4500 PARK GLEN RD STE 155
ST LOUIS PARK, MN
ZIP 55416-888
Phone: (952) 334-1213
Fax: (952) 928-9774

The NPI 1972672087 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 11/6/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinical15185MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
178612312-00MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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