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

MS. Charlene Mayson Portnoy, LICSWLMFT

Individual provider Clinical Social Worker · NPI 1578691606

MS. Charlene Mayson Portnoy, LICSWLMFT is a Clinical Social Worker in St Louis Park, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2007
Specialties on file
2

Practice location Address checks out

6465 Wayzata Blvd Ste 355
St Louis Park, MN 55426-1730
Phone: (612) 760-2859
Fax: (612) 926-8915
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 01769 (MN)
Marriage & Family Therapist Taxonomy 106H00000X · Licence 0361 (MN)

Record details

NPI number1578691606
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSWLMFT
Sole proprietorYes
NPI enumeratedMarch 1, 2007
Last updated in NPPESSeptember 20, 2016

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