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MRS. KERRY EDNA MCDONALD LICSW
NPI 1205928363
Social Worker - Clinical in Minneapolis, MN

Active since September 28, 2006Opted out of Medicare · through Jan 1, 2028
5208 BLOOMINGTON AVE S, MINNEAPOLIS, MN 55417(612) 205-9745(612) 822-2116 Get Directions Write a Review

NPPES record last updated: May 1, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Kerry Edna Mcdonald Licsw NPPES

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

MRS. KERRY EDNA MCDONALD LICSW (NPI 1205928363) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (13929) and active in the NPI registry since September 2006. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1205928363
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. KERRY EDNA MCDONALDCredential: LICSW
Location Address5208 BLOOMINGTON AVE SMinneapolis, MN 55417
Mailing Address5208 Bloomington Ave SMinneapolis, MN 55417 · (612) 205-9745 · Fax (612) 822-2116
Phone(612) 205-9745
Fax(612) 822-2116
Sole ProprietorYes
Enumeration DateSeptember 28, 2006
Last NPPES UpdateMay 1, 2017
✔ NPI 1205928363 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 · 13929
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.
5208 BLOOMINGTON AVE S, Minneapolis, MN 55417
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Other Names 1

Former Name (1)Mrs. Kerry Mcdonald Mokalla, Licsw, Llc

Other Identifiers 1

Medicaid924691600MN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Kerry Edna Mcdonald Licsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

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

MANZANITA THERAPY, LLC
Social Worker (Clinical)
5208 BLOOMINGTON AVE S
MINNEAPOLIS, MN 55417
Hennepin County (612) 246-6689

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 Kerry Mcdonald's NPI number?

The NPI number for Kerry Mcdonald is 1205928363. It was assigned to this individual provider in the NPPES registry on September 28, 2006. The provider is also known as Mrs. Kerry Mcdonald Mokalla, Licsw, LLC.

Where is Kerry Mcdonald located?

Kerry Mcdonald practices at 5208 Bloomington Ave S, Minneapolis, MN 55417. The listed phone number is (612) 205-9745.

What is Kerry Mcdonald's specialty?

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

Is Kerry Mcdonald enrolled in Medicare?

No. Kerry Mcdonald has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Kerry Mcdonald was last updated on May 1, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.