IndividualActive
Dianne Gordon, LICSW
NPI 1154544096 · Clinical Social Worker · Coon Rapids, MN
Provider details
- NPI number
- 1154544096
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LICSW
- Sex
- Female
- Sole proprietor
- No
- License
- 7835 (MN)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11427 Hanson Blvd Nw
Coon Rapids, MN 55433-3719
Phone: (763) 754-1531
Fax: (763) 754-3155
Street-level locationGet directions
Mailing address
11427 Hanson Blvd Nw
Coon Rapids, MN 55433-3719
Registry dates
- Enumerated
- 2007-04-10
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.