D'UNDRA WILLIS LICSW
NPI 1043747926
Social Worker - Clinical in Fridley, MN

Active since May 22, 2017
1250 MOORE LAKE DR E STE 205D, FRIDLEY, MN 55432(612) 412-4819(651) 304-6027 Get Directions Write a Review

NPPES record last updated: November 22, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 22, 2024, May 22, 2017 (2 updates tracked since 2017).

About D'undra Willis Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

D'UNDRA WILLIS LICSW (NPI 1043747926) is an individual clinical provider in Fridley, Minnesota, licensed in Minnesota (23648) and active in the NPI registry since May 2017.

NPPES Registry Identity

NPI1043747926
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameD'UNDRA WILLISCredential: LICSW
Location Address1250 MOORE LAKE DR E STE 205DFridley, MN 55432-5176
Mailing Address1250 Moore Lake Dr E Ste 205dFridley, MN 55432-5176 · (612) 412-4819 · Fax (651) 304-6027
Fax(651) 304-6027
Sole ProprietorYes
Enumeration DateMay 22, 2017
Last NPPES UpdateNovember 22, 20242 updates tracked since enumeration
NPPES CertifiedNovember 22, 2024
NPI 1043747926 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in MN · 23648
Definition

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.

1250 MOORE LAKE DR E STE 205D, Fridley, MN 55432

Other Identifiers 2

Other23648MN · Mn Board Of Sw
OtherQ577186700819MN · Drivers Liscense

Accepted Insurance

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
1250 MOORE LAKE DR E STE 205D
FRIDLEY, MN 55432

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is D'undra Willis's NPI number?

The NPI number for D'undra Willis is 1043747926. It was assigned to this individual provider in the NPPES registry on May 22, 2017.

Where is D'undra Willis located?

D'undra Willis practices at 1250 Moore Lake Dr E Ste 205D, Fridley, MN 55432. The listed phone number is (612) 412-4819.

What is D'undra Willis's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

What insurance does D'undra Willis accept?

Health plans from HealthPartners list D'undra Willis as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for D'undra Willis was last updated on November 22, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.