MS. ALEIYA MARIELLE PENN LICSW
NPI 1043174063
Social Worker - Clinical in Minneapolis, MN

Q: What is Aleiya Penn's NPI number?

The NPI number for Aleiya Penn is 1043174063. It was assigned to this individual provider in the NPPES registry on December 13, 2025.

Q: What is Aleiya Penn's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Aleiya Penn was last updated on December 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 13, 2025PECOS Enrolled

4208 PARK GLEN RD, MINNEAPOLIS, MN 55416(612) 825-4792(626) 727-7535 Get Directions Write a Review

NPPES record last updated: December 13, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Ms. Aleiya Marielle Penn Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. ALEIYA MARIELLE PENN LICSW (NPI 1043174063) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (31676) and active in the NPI registry since December 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1043174063

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMS. ALEIYA MARIELLE PENNCredential: LICSW

Location Address4208 PARK GLEN RDMinneapolis, MN 55416-4758

Mailing Address3700 Colfax Ave S Apt 2Minneapolis, MN 55409-1024 · (952) 220-4076

Phone(612) 825-4792

Fax(626) 727-7535

Sole ProprietorYes

Medical School CMSOtherGraduated 2022

Enumeration DateDecember 13, 2025

NPPES CertifiedDecember 13, 2025

✔ NPI 1043174063 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in MN · 31676

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

4208 PARK GLEN RD, Minneapolis, MN 55416

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Aleiya Marielle Penn Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9133688740

PECOS Enrollment IDI20260825001268

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Aleiya Penn reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Cgc LLC

0.2 mi

Mental Health (Including Community Mental Health Center)

4208 PARK GLEN RD
Minneapolis, MN 55416

Reassigned Medicare billing, Minnesota enrollment
31 clinicians in this Medicare group

NPI 1699239566 (630) 677-5437

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55416 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $56.00 – $168.28

Typical copayment $0.00 (range $14.00 – $42.07)

Most-billed visit code NA

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAYLENE ZICKMUND

Counselor