MS. SHELLEY LEE FOSSUM LICSW
NPI 1619130325
Social Worker - Clinical in Saint Cloud, MN

Q: What is Shelley Fossum's NPI number?

The NPI number for Shelley Fossum is 1619130325. It was assigned to this individual provider in the NPPES registry on July 3, 2008.

Q: What is Shelley Fossum'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 Shelley Fossum was last updated on January 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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 July 03, 2008

4801 VETERANS DR, SAINT CLOUD, MN 56303(320) 255-6480(320) 255-6326 Get Directions Write a Review

NPPES record last updated: January 29, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Ms. Shelley Lee Fossum Licsw NPPES

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

MS. SHELLEY LEE FOSSUM LICSW (NPI 1619130325) is an individual clinical provider in Saint Cloud, Minnesota, licensed in Minnesota (16251) and active in the NPI registry since July 2008.

NPPES Registry Identity

NPI1619130325

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMS. SHELLEY LEE FOSSUMCredential: LICSW

Location Address4801 VETERANS DRSaint Cloud, MN 56303-2015

Mailing Address4801 Veterans DrSaint Cloud, MN 56303-2015 · (320) 255-6480 · Fax (320) 255-6326

Phone(320) 255-6480

Fax(320) 255-6326

Sole ProprietorYes

Enumeration DateJuly 3, 2008

Last NPPES UpdateJanuary 29, 2025

NPPES CertifiedJanuary 29, 2025

✔ NPI 1619130325 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 · 16251

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.

4801 VETERANS DR, Saint Cloud, MN 56303

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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.

PATRICIA ANN MEYER LICSW

Social Worker (Clinical)