Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Alyssa Marie Whiteaker, LICSW

Individual provider Clinical Social Worker · NPI 1053041467

Alyssa Marie Whiteaker, LICSW is a Clinical Social Worker in Saint Paul, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2022
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

111 Kellogg Blvd E Apt 708
Saint Paul, MN 55101-1206
Phone: (651) 800-1302
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 24895 (MN)

Record details

NPI number1053041467
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedJune 16, 2022
Last updated in NPPESJune 16, 2022
Certification dateJune 16, 2022

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