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

Rebecca J Mellstrom, LICSW

Individual provider Clinical Social Worker · NPI 1518787985

Rebecca J Mellstrom, LICSW is a Clinical Social Worker in Bloomington, Minnesota. Qualified in 2021, 5 years ago. Practices with Fraser Child and Family Center, a 55-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
5
Licensed in
MN
In the registry since
2024
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

1801 American Blvd E
Bloomington, MN 55425-1232
Phone: (651) 424-4412
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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 30036 (MN)

Record details

NPI number1518787985
Entity typeIndividual (Type 1)
GenderNot disclosed
Credentials LICSW
Sole proprietorNo
NPI enumeratedOctober 11, 2024
Last updated in NPPESOctober 11, 2024
Certification dateOctober 11, 2024

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Fraser Child And Family Center — 55 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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