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MELISSA GRACE BENNETT LICSW
NPI 1104690163
Social Worker - Clinical in Maple Grove, MN

Active since November 09, 2023PECOS Enrolled
11671 FOUNTAINS DR N STE 200, MAPLE GROVE, MN 55369(612) 223-8898 Get Directions Write a Review

NPPES record last updated: May 20, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 20, 2026, Nov 9, 2023 (2 updates tracked since 2023).

About Melissa Grace Bennett Licsw NPPES

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

MELISSA GRACE BENNETT LICSW (NPI 1104690163) is an individual clinical provider in Maple Grove, Minnesota, licensed in Minnesota (33168) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1104690163
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMELISSA GRACE BENNETTCredential: LICSW
Location Address11671 FOUNTAINS DR N STE 200Maple Grove, MN 55369-4784
Mailing Address11671 Fountains Dr N Ste 200Maple Grove, MN 55369-4784 · (612) 223-8898
Phone(612) 223-8898
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateNovember 9, 2023
Last NPPES UpdateMay 20, 20262 updates tracked since enumeration
NPPES CertifiedMay 20, 2026
✔ NPI 1104690163 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 · 33168
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.
11671 FOUNTAINS DR N STE 200, Maple Grove, MN 55369
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Melissa Grace Bennett Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3577035500
PECOS Enrollment IDI20260610003794
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55369 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

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

MRS. JORDAN LYNN ALABASE LGSW
Social Worker
11671 FOUNTAINS DR N STE 200
MAPLE GROVE, MN 55369
Hennepin County (612) 223-8898

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Melissa Bennett's NPI number?

The NPI number for Melissa Bennett is 1104690163. It was assigned to this individual provider in the NPPES registry on November 9, 2023.

Where is Melissa Bennett located?

Melissa Bennett practices at 11671 Fountains Dr N Ste 200, Maple Grove, MN 55369. The listed phone number is (612) 223-8898.

What is Melissa Bennett's specialty?

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

Is Melissa Bennett enrolled in Medicare?

Yes. Melissa Bennett is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Melissa Bennett was last updated on May 20, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.