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

Individual provider Clinical Social Worker · NPI 1538792700

Katherine Lynn Desannoy, LICSW is a Clinical Social Worker in Minneapolis, Minnesota. Qualified in 2006, 20 years ago. Practices with Fairview Express Care, a 1,964-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
20
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.

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Practice location Address checks out

1100 Glenwood Ave
Minneapolis, MN 55405-1430
Phone: (612) 871-1454
Fax: (612) 871-1505
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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 24822 (MN)

Record details

NPI number1538792700
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedFebruary 17, 2020
Last updated in NPPESFebruary 17, 2020
Certification dateFebruary 17, 2020

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Fairview Express Care — 1964 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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