Brenda Melissia Anderson, LICSW
Individual provider Active NPI Clinical Social Worker · Crookston, MN
NPI 1366401481 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1366401481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 09419 (MN)
- Practice address
- 603 Bruce St
Crookston, MN 56716 - Phone
- (218) 281-3940
- Fax
- (218) 281-6261
- NPI assigned
- Mar 18, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09419 | MN | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 09419 | MN | Yes |
Addresses
Primary practice location
603 Bruce St
Crookston, MN 56716
Mailing address
PO Box 603
603 Bruce St
Crookston, MN 56716-0603
Phone (218) 281-3940
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1031784 | Other | PREFERRED ONE | |
| 6252818 | Other | UBH MEDICA | |
| 116598 | Other | MN | UCARE MINNESOTA |
| HP28519 | Other | HEALTH PARTNERS | |
| 17964 | Other | ND | BCBS OF ND |
| 9H592AN | Other | MN | BCBS BHSI |
Other names
- Brenda Melissia Mack
Other providers in Crookston, MN
- Altru Health System Ambulatory Surgery Centers LLC
- Altru Specialty Services, Inc.
- Altru Specialty Services, Inc.
- Cheri Lynn Ames
- Debra Kay Ames
- Casandra Kay Anderson
- Lisa Danielle Wikoff Anderson
- Michael Richard Anderson
- Emily Ann Andrews
- Janelle Bernice Artmann
All providers in Crookston, MN · Clinical Social Worker in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.