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

Individual provider Clinical Social Worker · NPI 1366940512

Mary Gonzalez, LICSW is a Clinical Social Worker in Saint Paul, Minnesota. Qualified in 2013, 13 years ago. Practices with Family Innovations Inc, a 93-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
13
Licensed in
MN
In the registry since
2018
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

2265 Como Ave
Saint Paul, MN 55108-1737
Phone: (651) 645-5323
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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 23259 (MN)

Record details

NPI number1366940512
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedJanuary 23, 2018
Last updated in NPPESJanuary 30, 2018

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Family Innovations Inc — 93 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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