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

Tammy M Gagnon, MSW, LICSW

Individual provider Clinical Social Worker · NPI 1013408681

Tammy M Gagnon, MSW, LICSW is a Clinical Social Worker in Mankato, Minnesota. Qualified in 2015, 11 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
11
Licensed in
MN
In the registry since
2018
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
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

11 Civic Center Plz Ste 1615
Mankato, MN 56001-7710
Phone: (507) 345-4679
Fax: (507) 345-8685
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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 22386 (MN)

Record details

NPI number1013408681
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSW , LICSW
Sole proprietorYes
NPI enumeratedMay 19, 2018
Last updated in NPPESDecember 5, 2023
Certification dateDecember 5, 2023

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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