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

Mackenna Delores Sullivan, LGSW

Individual provider Clinical Social Worker · NPI 1053237339

Mackenna Delores Sullivan, LGSW is a Clinical Social Worker in Edina, Minnesota. Licensed in Minnesota. Registered with an NPI since 2026.

Licensed in
MN
In the registry since
2026

Practice location Address checks out

4820 77th St W Ste 130
Edina, MN 55435-4832
Phone: (651) 313-8080
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 29680 (MN)

Record details

NPI number1053237339
Entity typeIndividual (Type 1)
GenderFemale
Credentials LGSW
Sole proprietorNo
NPI enumeratedJune 29, 2026
Last updated in NPPESJune 29, 2026
Certification dateJune 29, 2026

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