Michelle R. Mandell-Paulson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13758 Issued in MN

Practice address

11165 Zealand Ave N
Champlin, MN 55316-3595

Phone

(763) 531-0566

NPI assigned

Sep 8, 2017

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

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Group practices

North Therapy and Wellness PAGroup PAC ID 3870545668, 5 clinicians

Lake and Valley Family Therapy, LLCGroup PAC ID 5193249449, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• North Therapy and Wellness PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Champlin, MN
  • NPI 1265462212
  Medicare reassignment Care Compare group NPD
• Lake and Valley Family Therapy LLC

  • Marriage & Family Therapist
  • White Bear Lake, MN
  • NPI 1578262333
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1912425158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11165 ZEALAND AVE N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163595",
            "telephone_number": "763-531-0566",
            "fax_number": "763-531-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11165 ZEALAND AVE N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163595",
            "telephone_number": "763-531-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDELL-PAULSON",
        "first_name": "MICHELLE",
        "middle_name": "R.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keli Jo Loberg
• Laura Jean Lofy, PHD
• Yejay Lor
• Luxottica of America Inc
• Magdalene Maghanga
• Adenike Maruff
• Mayfair Home Health LLC
• Nicholas Michael McCarty, DC
• Morgan McCarver
• Brenna Lynn McKelvey, PA-C

• Clinical Social Worker in Champlin, MN
• Providers in Champlin, 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 Feb 13, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.