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

Amy Melissa Habedank, LICSW

Individual provider Clinical Social Worker · NPI 1679417695

Amy Melissa Habedank, LICSW is a Clinical Social Worker in Forest Lake, Minnesota. Qualified in 2022, 4 years ago. Works from 2 locations. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2026
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

1068 Lake St S Ste 109
Forest Lake, MN 55025-2633
Phone: (651) 982-4792
Fax: (651) 982-6035
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 570 Professional Dr, Northfield, MN 55057-2756 — (507) 301-3412

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 11936 (MN)

Record details

NPI number1679417695
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedApril 18, 2026
Last updated in NPPESApril 24, 2026
Certification dateApril 24, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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