1. Home
  2. Directory
  3. Minnesota
  4. Minneapolis
  5. Social Worker
  6. NPI Profile

NICOLE ANNE MUKANDA MSW, LICSW
NPI 1750904439
Social Worker - Clinical in Minneapolis, MN

Active since May 28, 2020
1825 CHICAGO AVE, MINNEAPOLIS, MN 55404(612) 752-8200(612) 752-8201 Get Directions Write a Review

NPPES record last updated: May 28, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Nicole Anne Mukanda Msw, Licsw NPPES

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

NICOLE ANNE MUKANDA MSW, LICSW (NPI 1750904439) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (22890) and active in the NPI registry since May 2020.

NPPES Registry Identity

NPI1750904439
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameNICOLE ANNE MUKANDACredential: MSW, LICSW
Location Address1825 CHICAGO AVEMinneapolis, MN 55404-1939
Mailing Address1825 Chicago AveMinneapolis, MN 55404-1939 · (612) 752-8200 · Fax (612) 752-8201
Phone(612) 752-8200
Fax(612) 752-8201
Sole ProprietorNo
Enumeration DateMay 28, 2020
NPPES CertifiedMay 28, 2020
✔ NPI 1750904439 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 · 22890
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.
1825 CHICAGO AVE, Minneapolis, MN 55404
Open in Google Maps ↗

Other Names 1

Former Name (1)Nicole Anne Stulac

Other Providers at the Same Location NPPES 13

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

MR. KEITH LESLIE DERAAD CPRP
Counselor (Mental Health)
1825 CHICAGO AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 752-8246
RESOURCE, INC.
Case Management
1825 CHICAGO AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 752-8200
CHARLIE LENTZ MS
Counselor
1825 CHICAGO AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 752-8206
RESOURCE, INC.
Case Management
1825 CHICAGO AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 752-8200
RESOURCE, INC.
Case Management
1825 CHICAGO AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 752-8200
MRS. CARRIE L JOHNSON MSW, LICSW
Social Worker (Clinical)
1825 CHICAGO AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 752-8216
AVIVO
Community/Behavioral Health
1825 CHICAGO AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 752-8200
EMILY ANN BASTIAN L.I.C.S.W.
Social Worker (Clinical)
1825 CHICAGO AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 752-8236

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 Nicole Mukanda's NPI number?

The NPI number for Nicole Mukanda is 1750904439. It was assigned to this individual provider in the NPPES registry on May 28, 2020. The provider is also known as Nicole Anne Stulac.

Where is Nicole Mukanda located?

Nicole Mukanda practices at 1825 Chicago Ave, Minneapolis, MN 55404. The listed phone number is (612) 752-8200.

What is Nicole Mukanda'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 Nicole Mukanda was last updated on May 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.