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

Katie Moses Sullivan, LICSW

Individual provider Clinical Social Worker · NPI 1790337095

Katie Moses Sullivan, LICSW is a Clinical Social Worker in Minneapolis, Minnesota. Licensed in Minnesota. Registered with an NPI since 2019.

Licensed in
MN
In the registry since
2019
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 17997 (MN)

Record details

NPI number1790337095
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedJuly 16, 2019
Last updated in NPPESJuly 22, 2026
Certification dateJuly 22, 2026

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