DR. SANDRA SUE SMITH HANEN (NPI# 1750480679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750480679 |
| Entity Type | Individual |
| Full Name | DR. SANDRA SUE SMITH HANEN |
| Credential | EDD |
| Practice Address |
4323 E Lake St Minneapolis MN 55406-2307 |
| Practice Telephone | 6127221003 |
| Practice Fax Number | 6127216336 |
| Mailing Telephone | 6127221003 |
| Mailing Fax Number | 6127216336 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2014-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | LP2754 | MN | Behavioral Health & Social Service Providers |
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
LP2754 | MN | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
LP2754 | MN | Behavioral Health & Social Service Providers |
| N | 103TC1900X |
Psychologist Specialization: Counseling |
LP2754 | MN | Behavioral Health & Social Service Providers |
| N | 103TF0000X |
Psychologist Specialization: Family |
LP2754 | MN | Behavioral Health & Social Service Providers |
| N | 103TF0200X |
Psychologist Specialization: Forensic |
LP2754 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | UCARE | 100479 | 01 |
| MN | BCBS | 064925M | 01 |
| MN | 432747100 | 05 | |
| MN | MEDICA | 6180090 | 01 |
| Street Address |
4323 E LAKE ST |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55406-2307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407293061 | Joshua Jessie Dewar Smith Hanen | Optometrist | 4323 E Lake St, Minneapolis, MN 55406-2307 | 2013-05-22 |
| 1902932965 | River Lake Clinic LLC | Optometrist | 4323 E Lake St, Minneapolis, MN 55406-2307 | 2007-02-26 |
| 1326119223 | Michel E Hanen Smith | Optometrist | 4323 E Lake St, Minneapolis, MN 55406-2307 | 2006-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286221 | Hoa Bui | Pharmacist | 4547 Hiawatha, Minneapolis, MN 55406 | 2020-08-17 |
| 1184263253 | Carrie Shannon Nightshade | Acupuncturist | 3706 E 42nd Street, Minneapolis, MN 55406 | 2020-01-06 |
| 1164060059 | Deborah Owen | Acupuncturist | 3706 E 42nd St, Minneapolis, MN 55406 | 2019-12-11 |
| 1194290593 | Noelle Therese Wolf | Counselor | 2637 27th Ave S # 229, Minneapolis, MN 55406 | 2018-10-11 |
| 1255819819 | Ayan Osman Ali | Behavior Technician | 3355 Haiwatha Ave Suite 100, Minneapolis, MN 55406 | 2018-08-04 |
| 1881188597 | Lydia Joy Allison | Massage Therapist | 2933 29th Ave. S., Minneapolis, MN 55406 | 2018-06-15 |
| 1497261770 | Carroll Lee Beaty | Massage Therapist | 2801 42nd Ave. So., Minneapolis, MN 55406 | 2017-12-21 |
| 1578082798 | Capitol Cafe LLC | Home Delivered Meals | 2417 E Franklin Ave, Capitol Cafe, Minneapolis, MN 55406 | 2017-09-19 |
| 1851823942 | Safia Abdulkadir Mohamud | Contractor | 2740 Minnehaha Ave Suit 100, Minneapolis, MN 55406 | 2017-03-29 |
| 1881051944 | Sos Transportation LLC | Non-emergency Medical Transport (VAN) | 3355 Haiwatha Ave Suit 100, Minneapolis, MN 55406 | 2016-01-20 |
| Find all providers in zip 55406 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407496516 | Liza N Meredith | Psychologist | Acacia Counseling and Wellness, 2724 University Ave Se Unit B, Minneapolis, MN 55414 | 2020-01-07 |
| 1194368191 | Luz Angelica Fehn Salinas | Psychologist | 1315 E24th St, Minneapolis, MN 55404 | 2019-10-22 |
| 1164071148 | Amy C Moran | Psychologist | Acacia Counseling & Wellness, 2724 University Ave., Unit B, Minneapolis, MN 55414 | 2019-09-11 |
| 1104482074 | Sanvello Behavioral Health Services, P.a. | Psychologist | 150 S 5th St Ste 825, Minneapolis, MN 55402-4200 | 2019-05-15 |
| 1033674726 | Kristina Marie Duncombe Lowe | Psychologist | 910 E 26th St Ste 410, Minneapolis, MN 55404-4512 | 2019-02-06 |
| 1083192223 | Krista Yucuis | Psychologist | 725 8th Ave Se, Minneapolis, MN 55414-1364 | 2018-07-31 |
| 1720564941 | Shani Ofrat | Psychologist | 1 Veterans Dr # 2g-128, Minneapolis, MN 55417-2309 | 2018-07-11 |
| 1962998997 | Steven Wolinski | Psychologist | 3830 Washburn Ave N, Minneapolis, MN 55412 | 2018-07-02 |
| 1497268122 | Andrea Lynn Potthoff | Psychologist | 7300 Metro Blvd Ste 640, Minneapolis, MN 55439-2313 | 2017-11-16 |
| 1871046912 | Christine E Bray | Psychologist | 1100 Washington Ave S, Suite 102, Minneapolis, MN 55415-1273 | 2016-07-25 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55406 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.