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KRIS MALLON HENNELLY MSW, LICSW
NPI 1417031824
Social Worker - Clinical in Minneapolis, MN

Active since October 24, 2006PECOS Enrolled
4027 COUNTY ROAD 25, MINNEAPOLIS, MN 55416(612) 925-6033(612) 925-8496 Get Directions Write a Review

NPPES record last updated: May 22, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 22, 2026, Jun 26, 2018 (2 updates tracked since 2018).

About Kris Mallon Hennelly Msw, Licsw NPPES

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

KRIS MALLON HENNELLY MSW, LICSW (NPI 1417031824) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (17387) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417031824
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKRIS MALLON HENNELLYCredential: MSW, LICSW
Location Address4027 COUNTY ROAD 25Minneapolis, MN 55416-2629
Mailing Address4240 Park Glen RdSt Louis Park, MN 55416-5427 · (612) 925-6033 · Fax (612) 925-8496
Phone(612) 925-6033
Fax(612) 925-8496
Sole ProprietorNo
Enumeration DateOctober 24, 2006
Last NPPES UpdateMay 22, 20262 updates tracked since enumeration
NPPES CertifiedMay 22, 2026
✔ NPI 1417031824 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 · 17387
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.
4027 COUNTY ROAD 25, Minneapolis, MN 55416
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Other Names 1

Former Name (1)Kris Mallon

Other Identifiers 1

Medicaid106649800MN

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kris Mallon Hennelly Msw, Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 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 20

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

ALEX JACOB HOYT MSW, LICSW
Social Worker (Clinical)
4027 COUNTY ROAD 25
MINNEAPOLIS, MN 55416
Hennepin County (612) 925-6033
DR. DIANE LOUISE STELLRECHT PHD, LP
Psychologist (Clinical)
4027 COUNTY ROAD 25
MINNEAPOLIS, MN 55416
Hennepin County (612) 925-6033
SARAH JOY NAJAFALIPOUR MA, LPCC
Counselor (Professional)
4027 COUNTY ROAD 25
ST LOUIS PARK, MN 55416
Hennepin County (612) 925-6033
LESLIE ALLENE WISE MS, LPCC
Counselor (Professional)
4027 COUNTY ROAD 25
MINNEAPOLIS, MN 55416
Hennepin County (612) 925-6033
BRITTANY KAY SUNDER MS, LPCC
Counselor (Professional)
4027 COUNTY ROAD 25
MINNEAPOLIS, MN 55416
Hennepin County (612) 925-6033
ANN MARIE BATTLE MSSW, LICSW
Social Worker (Clinical)
4027 COUNTY ROAD 25
MINNEAPOLIS, MN 55416
Hennepin County (612) 925-6033
KRISTIN MARIE ANTTILA MSW, LICSW
Social Worker (Clinical)
4027 COUNTY ROAD 25
MINNEAPOLIS, MN 55416
Hennepin County (612) 925-6033
DR. ERICA LEE STELLICK-WOODS PSYD, LP
Psychologist (Clinical)
4027 COUNTY ROAD 25
ST LOUIS PARK, MN 55416
Hennepin County (612) 925-6033

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 Kris Hennelly's NPI number?

The NPI number for Kris Hennelly is 1417031824. It was assigned to this individual provider in the NPPES registry on October 24, 2006. The provider is also known as Kris Mallon.

Where is Kris Hennelly located?

Kris Hennelly practices at 4027 County Road 25, Minneapolis, MN 55416. The listed phone number is (612) 925-6033.

What is Kris Hennelly's specialty?

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

Is Kris Hennelly enrolled in Medicare?

Yes. Kris Hennelly is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kris Hennelly was last updated on May 22, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.