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

Mallory Bushey, LICSW

Individual provider Social Worker · NPI 1437789104

Mallory Bushey, LICSW is a Social Worker in Saint Paul, Minnesota. Licensed in Minnesota. Registered with an NPI since 2020.

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

640 Jackson St
Saint Paul, MN 55101-2502
Phone: (651) 254-3448
Fax: (651) 254-3470
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 22308 (MN)

Record details

NPI number1437789104
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedJanuary 22, 2020
Last updated in NPPESMarch 10, 2021
Certification dateMarch 10, 2021

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