Active NPI
Alicia Marie Malisheski, LICSW
- Clinical Social Worker
- Maple Grove, MN
National Provider Identifier
1891535324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 30172
- Practice address
- 11671 Fountains Dr Ste 200
Maple Grove, MN 55369-4784 - Phone
- (612) 223-8898
- NPI assigned
- May 31, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 30172 | MN | Primary |
Addresses
Primary practice location
11671 Fountains Dr Ste 200
Maple Grove, MN 55369-4784
Mailing address
11671 Fountains Dr N Ste 200
Maple Grove, MN 55369-4784
Phone (612) 223-8898
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30172 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780012800000",
"number": "1891535324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11671 FOUNTAINS DR N STE 200",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553694784",
"telephone_number": "612-223-8898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11671 FOUNTAINS DR STE 200",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553694784",
"telephone_number": "612-223-8898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALISHESKI",
"first_name": "ALICIA",
"middle_name": "MARIE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-31",
"last_updated": "2026-05-29",
"certification_date": "2026-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "30172",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.