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

Individual provider Clinical Social Worker · NPI 1477332443

Jessica Coburn, MSW, LICSW is a Clinical Social Worker in Grand Rapids, Minnesota. Qualified in 2021, 5 years ago. Practices with Lakeview Behavioral Health Inc, a 24-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
5
Licensed in
MN
In the registry since
2023
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

2310 NW 3rd St
Grand Rapids, MN 55744-2135
Phone: (218) 328-3214
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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 30094 (MN)

Record details

NPI number1477332443
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSW , LICSW
Sole proprietorNo
NPI enumeratedSeptember 27, 2023
Last updated in NPPESApril 24, 2025
Certification dateApril 24, 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)
Group practice Lakeview Behavioral Health Inc — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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