IndividualActive
Gary Keifenheim, MSW, LICSW
NPI 1205903705 · Clinical Social Worker · Brooklyn Park, MN
Provider details
- NPI number
- 1205903705
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- MSW, LICSW
- Sex
- Male
- Sole proprietor
- Yes
- License
- LICSW06601 (MN)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(90/100 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
6900 78th Ave N
Brooklyn Park, MN 55445-2719
Phone: (763) 560-4412
Street-level locationGet directions
Mailing address
19425 Irving Circle
Elk River, MN 55330
Registry dates
- Enumerated
- 2006-11-29
- 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.