Alissa Menke, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24905 Issued in MN

Practice address

200 4TH Ave W
Shakopee, MN 55379-1220

Phone

(952) 496-8565

NPI assigned

Apr 30, 2018

Last updated

Jan 9, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• County of Scott

  dba Scott County Mental Health Center

  • Psychologist
  • Shakopee, MN
  • NPI 1841299443
  Medicare reassignment NPD
• County of Scott

  • Public Health or Welfare Agency
  • Shakopee, MN
  • NPI 1821156183
  NPD

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1518455096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 4TH AVE W",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791220",
            "telephone_number": "952-496-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 4TH AVE W",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791220",
            "telephone_number": "952-496-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENKE",
        "first_name": "ALISSA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-30",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Marie McMahon, DDS
• Kyle McNett
• Elizabeth Islay McPeek, MSW, LICW, LCSW
• Tania Mejia
• Connie Lynn Melby
• Mercy Sunrise Home Care LLC
• Jennifer Meyer
• Sarah E Mickelsen, LMFT
• Jerrald C Miller, D.C.
• Linda Louise Miller, MA LP

• Clinical Social Worker in Shakopee, MN
• Providers in Shakopee, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.