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

Individual provider Clinical Psychologist · NPI 1093698490

Ellen Therese Gormican, LICSW is a Clinical Social Worker in Minneapolis, Minnesota. Qualified in 2021, 5 years ago. Practices as a sole proprietor. Licensed in Minnesota.

Years since qualifying
5
Licensed in
MN
In the registry since
2025
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

3236 Longfellow Ave
Minneapolis, MN 55407-3805
Phone: (612) 807-6872
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 30671 (MN)

Record details

NPI number1093698490
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedJuly 31, 2025
Last updated in NPPESJuly 31, 2025
Certification dateJuly 31, 2025

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated

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