Individual provider · Type 1 NPI

Autumn Michelle Phenow, MSW, LICSW

Clinical Social Worker · Fridley, MN

NPI number 1154980068 Active

Practice location

6341 University Ave NE
Fridley, MN 55432-4946

Call (612) 672-6999 Map

Mailing address

2785 White Bear Ave N Ste 403
Maplewood, MN 55109-1327

Other practice locations

  • 3450 Oleary Ln, Eagan, MN 55123-2340 · (651) 363-0114

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X22651 (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 1154980068

Autumn Michelle Phenow, MSW, LICSW's National Provider Identifier is 1154980068, issued on Jun 13, 2019. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fridley, MN. The record was last updated on Aug 22, 2019.