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

Individual provider Clinical Social Worker · NPI 1104531458

Shannon Martina Rapalo Medina, LICSW is a Clinical Social Worker in Milwaukee, Wisconsin. Qualified in 2017, 9 years ago. Works from 3 locations. Licensed in Minnesota.

Years since qualifying
9
Licensed in
MN
In the registry since
2023
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

5404 N Lovers Lane Rd Ste 10
Milwaukee, WI 53225-3006
Phone: (218) 332-4771
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 5155 E River Rd Ste 401, Fridley, MN 55421-3777 — (763) 913-9184
  • 6417 Penn Ave S Ste 7-1055, Minneapolis, MN 55423-1186 — (218) 332-4771

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 26538 (MN)

Record details

NPI number1104531458
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedJanuary 20, 2023
Last updated in NPPESJune 4, 2026
Certification dateJune 4, 2026

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated

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