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

Individual provider Mental Health Counselor · NPI 1285817528

MS. Amy Elizabeth Mellum, LICSW is a Clinical Social Worker in St Paul, Minnesota. Qualified in 2004, 22 years ago. Practices with Lyn-Lake Psychotherapy and Wellness Ltd, a 72-clinician group. Licensed in Minnesota.

Years since qualifying
22
Licensed in
MN
In the registry since
2007
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

311 Ramsey St Ste 205
St Paul, MN 55102
Phone: (651) 262-9726
Fax: (651) 294-2347
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 17145 (MN)

Record details

NPI number1285817528
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedDecember 10, 2007
Last updated in NPPESMarch 28, 2012

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Lyn-Lake Psychotherapy And Wellness Ltd — 72 clinicians
Accepts Medicare assignment Not indicated

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