Individual provider Active NPI

Michelle Sanko, MSW, LICSW

  • Clinical Social Worker
  • Maple Grove, MN
National Provider Identifier
1215472212
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22135 Issued in MN
Practice address
17039 72ND Ave N
Maple Grove, MN 55311-4564
Phone
(507) 469-2084
NPI assigned
Dec 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22135 MN Primary

Addresses

Primary practice location

17039 72ND Ave N
Maple Grove, MN 55311-4564

Mailing address

17039 72ND Ave N
Maple Grove, MN 55311-4564
Phone (507) 469-2084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250929000794 MN Practitioner - Clinical Social Worker 7517462682 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

17039 72ND Ave N
Maple Grove, MN 55311-4564

503 Sterling St S
Maplewood, MN 55119-5579

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22135MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fraser Child and Family Center CurrentSince Aug 25, 2025 Accepting new patients
Ainga Mental Health and Consulting LLC Clinical CurrentSince Jan 1, 2026 Accepting new patients
Meadowlark Services LLC Clinical Current Accepting new patients

Locations

9120 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 231-2590

2400 W 64th St
Richfield, MN 55423
Phone (612) 767-5166

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1215472212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17039 72ND AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553114564",
            "telephone_number": "507-469-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17039 72ND AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553114564",
            "telephone_number": "507-469-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANKO",
        "first_name": "MICHELLE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-29",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.