Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jeff Shively, MSW, LICSW

Organization Clinical Social Worker · NPI 1366874299

Jeff Shively, MSW, LICSW is a Clinical Social Worker in Bloomington, Minnesota. Licensed in Minnesota. Registered with an NPI since 2013.

Licensed in
MN
In the registry since
2013

Practice location Address checks out

8120 Penn Ave S Ste 500E
Bloomington, MN 55431-1367
Phone: (612) 723-0408
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 18053 (MN)

Record details

NPI number1366874299
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeff Shively — President · (612) 723-0408
NPI enumeratedAugust 2, 2013
Last updated in NPPESAugust 5, 2026
Certification dateAugust 5, 2026
Mailing address8120 Penn Ave S Ste 500e, Bloomington, MN 55431-1367

Other providers in Bloomington