Individual provider · Type 1 NPI

Melissa Grace Bennett, LICSW

Clinical Social Worker · Maple Grove, MN

NPI number 1104690163 Active

Practice location

11671 Fountains Dr N Ste 200
Maple Grove, MN 55369-4784

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X33168 (MN)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1104690163

Melissa Grace Bennett, LICSW's National Provider Identifier is 1104690163, issued on Nov 9, 2023. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Maple Grove, MN. The record was last updated on May 20, 2026.