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

Mary Wetherall, LICSW

Individual provider Clinical Social Worker · NPI 1881570919

Mary Wetherall, LICSW is a Clinical Social Worker in Minneapolis, Minnesota. Graduated from University of Minnesota Medical School in 2022, 4 years ago. Practices with Edges Wellness Center LLC, an 8-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
4
Trained at
University of Minnesota Medical School
Licensed in
MN
In the registry since
2025
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

730 E 38th St
Minneapolis, MN 55407-5217
Phone: (612) 217-0584
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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 31509 (MN)

Record details

NPI number1881570919
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedAugust 13, 2025
Last updated in NPPESAugust 13, 2025
Certification dateAugust 13, 2025

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolUNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated 2022 (4 years in practice)
Group practice Edges Wellness Center Llc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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