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

Mikki Jo Rothbauer, MSW, LICSW

Individual provider Clinical Social Worker · NPI 1548642770

Mikki Jo Rothbauer, MSW, LICSW is a Clinical Social Worker in Saint Paul, Minnesota. Graduated from University of Minnesota Medical School in 2004, 22 years ago. Practices with Group Health Plan Inc, a 1,633-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
22
Trained at
University of Minnesota Medical School
Licensed in
MN
In the registry since
2015
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.

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Practice location Address checks out

640 Jackson St Burn Center C5400
Saint Paul, MN 55101-2502
Phone: (651) 254-2030
Fax: (651) 254-6870
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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 15399 (MN)

Record details

NPI number1548642770
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSW , LICSW
Sole proprietorNo
NPI enumeratedJune 24, 2015
Last updated in NPPESJune 24, 2015

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 2004 (22 years in practice)
Group practice Group Health Plan Inc — 1633 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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