Lisa M. Brennom, LICSW
NPI 1437179611ActiveIndividual· Social Worker, Clinical· Minnetonka, MN
Social Worker, Clinical (LICSW) in Minnetonka, Minnesota, trained at University of Minnesota Medical School (class of 1997). Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1437179611 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LICSW |
| Sole proprietor | No |
| NPI issued | Jul 20, 2006 |
| Last updated in NPPES | May 3, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 13588 | MS |
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
| Medical school | University of Minnesota Medical School |
|---|---|
| Graduation year | 1997 |
| Medicare specialty | Clinical Social Worker |
Medical group
- Affinity Psychological Services PCSaint Cloud, MN · 69 clinicians
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