Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JEFF SHIVELY, MSW, LICSW
NPI 1366874299
Social Worker - Clinical in Bloomington, MN

Active since August 02, 2013
8120 PENN AVE S STE 500E, BLOOMINGTON, MN 55431(612) 723-0408 Get Directions Write a Review

NPPES record last updated: August 5, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jeff Shively, Msw, Licsw NPPES

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

JEFF SHIVELY, MSW, LICSW (NPI 1366874299) is a healthcare organization registered as a clinical in Bloomington, Minnesota and active in the NPI registry since August 2013. The organization lists Jeff W Shively, President, as its authorized official.

NPPES Registry Identity

NPI1366874299
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameJEFF SHIVELY, MSW, LICSW
Location Address8120 PENN AVE S STE 500EBloomington, MN 55431-1367
Mailing Address8120 Penn Ave S Ste 500eBloomington, MN 55431-1367 · (612) 723-0408
Organization SubpartNo
Authorized OfficialJeff W ShivelyPresident · (612) 723-0408
Enumeration DateAugust 2, 2013
Last NPPES UpdateAugust 5, 2026
NPPES CertifiedAugust 5, 2026
NPI 1366874299 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 · 18053
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.
8120 PENN AVE S STE 500E, Bloomington, MN 55431

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Jeff Shively, Msw, Licsw's NPI number?

The NPI number for Jeff Shively, Msw, Licsw is 1366874299. It was assigned to this organization in the NPPES registry on August 2, 2013.

Where is Jeff Shively, Msw, Licsw located?

Jeff Shively, Msw, Licsw is located at 8120 Penn Ave S Ste 500E, Bloomington, MN 55431. The listed phone number is (612) 723-0408.

What is Jeff Shively, Msw, Licsw's specialty?

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

When was this NPI record last updated?

The NPPES record for Jeff Shively, Msw, Licsw was last updated on August 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days 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.