Amy Melissa Habedank, LICSW
NPI 1679417695ActiveIndividual· Social Worker, Clinical· Forest Lake, MN
Social Worker, Clinical (LICSW) in Forest Lake, Minnesota, licensed in MN, with an NPI issued in April 2026. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1679417695 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LICSW |
| Sole proprietor | No |
| NPI issued | Apr 18, 2026 |
| Last updated in NPPES | Apr 24, 2026 |
| Certified by provider | Apr 24, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 11936 | 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) |
|---|
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Clinical Social Worker |
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All 17 clinical social workers in Forest Lake · All clinical social workers in Minnesota