MS. AMY ELIZABETH MELLUM (LICSW) – Mental Health Counselor, NPI 1285817528

MS. AMY ELIZABETH MELLUM (LICSW) is a healthcare provider. based in St. paul, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 17145 (MN). The NPI Number for MS. AMY ELIZABETH MELLUM (LICSW) is 1285817528

Main info

Female
Sole Proprietor
22 Years Of Experience
Name
MS. AMY ELIZABETH MELLUM (LICSW)
NPI
1285817528
Phone
(651) 262-9726
Address
1137 SEMINARY AVE.
Enumeration Date
10 December 2007
Last Update Date
28 March 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6129792276
Graduation Year
2004 (22 years ago)
PAC ID
3476632464
Group Practice PAC ID
9638581291
Professional Enrollment ID
I20080501000545
Address ID
MN554082952MI621XXSTXX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

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Provider Addresses for MS. AMY ELIZABETH MELLUM (LICSW)

  • 1137 SEMINARY AVE.

    ST. PAUL, MN 55104

    Phone: (651) 262-9726

    Fax: (651) 294-2347

    Type: Mailing

  • Saint Paul, Ramsey County, Minnesota, United States

    ST. PAUL, MN 55102

    Phone: (651) 262-9726

    Fax: (651) 294-2347

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-05-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080501000545IClinical Social WorkerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55104)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638581291View full group profile
NameSpecialtyState
Clinical Social WorkerMN
Marriage And Family TherapistMN
Clinical Social WorkerMN
Clinical PsychologistMN
Clinical PsychologistMN
Mental Health CounselorMN
Clinical Social WorkerMN
Nurse PractitionerMN
Mental Health CounselorMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

Does MS. AMY ELIZABETH MELLUM (LICSW) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MS. AMY ELIZABETH MELLUM (LICSW) uses 1285817528.
Does the file indicate MS. AMY ELIZABETH MELLUM (LICSW) is practicing under active NPI?
Directory data currently reports MS. AMY ELIZABETH MELLUM (LICSW) as active.
What is MS. AMY ELIZABETH MELLUM (LICSW)'s specialty?
The listing groups MS. AMY ELIZABETH MELLUM (LICSW) with Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Where is MS. AMY ELIZABETH MELLUM (LICSW) based?
MS. AMY ELIZABETH MELLUM (LICSW) is tied to St. Paul, Minnesota in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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