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

Jamie Lee Mack, LICSW

Individual provider Clinical Social Worker · NPI 1104663525

Jamie Lee Mack, LICSW is a Clinical Social Worker in Mankato, Minnesota. Qualified in 2016, 10 years ago. Licensed in Minnesota.

Years since qualifying
10
Licensed in
MN
In the registry since
2024
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

1600 Madison Ave Ste 110
Mankato, MN 56001-5820
Phone: (651) 346-3266
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 23072 (MN)

Record details

NPI number1104663525
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedJuly 12, 2024
Last updated in NPPESJuly 12, 2024
Certification dateJuly 12, 2024
Mailing address118 Merlin Cir, Mankato, MN 56001-5732

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)
Accepts Medicare assignment Not indicated
Practice locations4 on file with Medicare

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