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

MS. Shelley Lee Fossum, LICSW

Individual provider Clinical Social Worker · NPI 1619130325

MS. Shelley Lee Fossum, LICSW is a Clinical Social Worker in Saint Cloud, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2008
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

4801 Veterans Dr
Saint Cloud, MN 56303-2015
Phone: (320) 255-6480
Fax: (320) 255-6326
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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 16251 (MN)

Record details

NPI number1619130325
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedJuly 3, 2008
Last updated in NPPESJanuary 29, 2025
Certification dateJanuary 29, 2025

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