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

Kelli Jo Clancy I, LICSW

Individual provider School Social Worker · NPI 1396601191

Kelli Jo Clancy I, LICSW is a Clinical Social Worker in Saint Paul, Minnesota. Qualified in 2008, 18 years ago. Licensed in Minnesota.

Years since qualifying
18
Licensed in
MN
In the registry since
2025
Specialties on file
2
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

640 Jackson St
Saint Paul, MN 55101-2595
Phone: (651) 254-1000
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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 16365 (MN)
School Social Worker Taxonomy 1041S0200X · Licence 16365 (MN)

Record details

NPI number1396601191
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedDecember 25, 2025
Last updated in NPPESDecember 25, 2025
Certification dateDecember 25, 2025

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Saint Paul