Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Autumn Michelle Phenow, MSW, LICSW

Individual provider Clinical Social Worker · NPI 1154980068

Autumn Michelle Phenow, MSW, LICSW is a Clinical Social Worker in Fridley, Minnesota. Qualified in 2016, 10 years ago. Practices with Fairview Express Care, a 1,964-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
10
Licensed in
MN
In the registry since
2019
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
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

6341 University Ave NE
Fridley, MN 55432-4946
Phone: (612) 672-6999
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

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

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 22651 (MN)

Record details

NPI number1154980068
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSW , LICSW
Sole proprietorNo
NPI enumeratedJune 13, 2019
Last updated in NPPESAugust 22, 2019

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Fairview Express Care — 1964 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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