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

Michelle Lee Gustafson, MSW, LICSW

Individual provider Clinical Social Worker · NPI 1700823952

Michelle Lee Gustafson, MSW, LICSW is a Clinical Social Worker in Mpls, Minnesota. Qualified in 1993, 33 years ago. Practices with Fairview Express Care, a 1,964-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
33
Licensed in
MN
In the registry since
2006
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

See every abbreviation used in this directory →

Practice location Partly verified

Some contact details are missing from the federal record.

Fairview University Hospital 2450 Riverside Ave S
Mpls, MN 55454
Phone: (612) 273-5640
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 10595 (MN)

Record details

NPI number1700823952
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSW , LICSW
Sole proprietorYes
NPI enumeratedMay 31, 2006
Last updated in NPPESJanuary 6, 2023
Certification dateJanuary 6, 2023

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Group practice Fairview Express Care — 1964 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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