Autumn Michelle Phenow, MSW, LICSW
NPI 1154980068ActiveIndividual· Social Worker, Clinical· Fridley, MN
Social Worker, Clinical (MSW, LICSW) with Fairview Express Care, practicing in Fridley, Minnesota. Medicare paid $8,051 for services to 28 patients in 2024.
Overview
| NPI | 1154980068 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MSW, LICSW |
| Sole proprietor | No |
| NPI issued | Jun 13, 2019 |
| Last updated in NPPES | Aug 22, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 22651 | MN |
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) | Enrolled Practitioner - Clinical Social Worker (MN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 28 |
|---|---|
| Services billed | 123 across 7 procedure codes |
| Paid by Medicare | $8,051 |
Education and affiliations
| Graduation year | 2016 |
|---|---|
| Medicare specialty | Clinical Social Worker |
| Telehealth | Offers telehealth |
Medical group
- Fairview Express CareMinneapolis, MN · 1,911 clinicians
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