Melissa Grace Bennett, LICSW
NPI 1104690163ActiveIndividual· Social Worker, Clinical· Maple Grove, MN
Social Worker, Clinical (LICSW) in Maple Grove, Minnesota, licensed in MN, with an NPI issued in November 2023. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1104690163 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LICSW |
| Sole proprietor | Yes |
| NPI issued | Nov 9, 2023 |
| Last updated in NPPES | May 20, 2026 |
| Certified by provider | May 20, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 33168 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (MN) |
|---|
Education and affiliations
| Graduation year | 2023 |
|---|---|
| Medicare specialty | Clinical Social Worker |
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