# MARY BETH DORNHEIM

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1356487227
- **Gender:** F
- **Credential:** LICSW

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 173889 | MN | — |
| 1041C0700X | Clinical Social Worker | 19740 | MN | Yes |
| 1041C0700X | Clinical Social Worker | 4781 | SD | — |

## Other

- **Enumeration date:** 01/29/2007
- **Last updated:** 05/28/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000498910 | UBH MEDICA | MN |
| 01 | — | 1356487227 | HEATH PARTNERS | MN |
| 01 | — | 330617000 | MINNESOTA HEALTH CARE PROGRAMS | MN |