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

Evan M Wallenfelsz, LICSW

Individual provider Social Worker · NPI 1912578188

Evan M Wallenfelsz, LICSW is a Social Worker in Maplewood, Minnesota. Licensed in Minnesota. Registered with an NPI since 2021.

Licensed in
MN
In the registry since
2021
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

2495 Maplewood Dr N Ste 312
Maplewood, MN 55109-1985
Phone: (651) 760-3109
Fax: (651) 760-3109
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 25117 (MN)

Record details

NPI number1912578188
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedJuly 8, 2021
Last updated in NPPESJuly 8, 2021
Certification dateJuly 8, 2021

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