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

Jacquelyn Deecarlo-Omoruyi, LICSW

Individual provider Clinical Social Worker · NPI 1285233965

Jacquelyn Deecarlo-Omoruyi, LICSW is a Clinical Social Worker in Minneapolis, Minnesota. Works from 2 locations. Licensed in Minnesota.

Licensed in
MN
In the registry since
2020
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

525 Portland Ave # MC963
Minneapolis, MN 55415-1533
Phone: (218) 969-0948
Fax: (612) 677-6248
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3333 University Ave Se, Minneapolis, MN 55414-3325 — (218) 969-0948

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 27320 (MN)

Record details

NPI number1285233965
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedOctober 22, 2020
Last updated in NPPESFebruary 12, 2021
Certification dateFebruary 12, 2021

Other providers in Minneapolis