Space To Be LLC
NPI 1689591273ActiveOrganization· Social Worker, Clinical· Eagan, MN
Social Worker, Clinical in Eagan, Minnesota, registered in NPPES in July 2026. The authorized official on file is Maia Shanae Jackson, MSW, LICSW, Psychotherapist.
Overview
| NPI | 1689591273 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 2, 2026 |
| Last updated in NPPES | Nov 5, 2026 |
| Certified by provider | Nov 5, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other clinical social workers in Eagan
- 1033645395
- 1043443500
- 1043745078
- 1184718165
- 1235221441
- 1306694997
- 1376044149
- 1477929990
- 1609551472
- 1619197167
- 1750366167
- 1811870306
All 82 clinical social workers in Eagan · All clinical social workers in Minnesota