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

Individual provider Social Worker · NPI 1265085724

Marissa Pethsala Melby, MSWLGSW is a Social Worker in Minneapolis, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2019
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Practice location Address checks out

1121 Jackson St NE Ste 105
Minneapolis, MN 55413-1665
Phone: (612) 874-7063
Fax: (612) 874-8445
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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 27609 (MN)

Record details

NPI number1265085724
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSWLGSW
Sole proprietorYes
NPI enumeratedJuly 23, 2019
Last updated in NPPESJuly 23, 2019

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