Individual provider Active NPI

Benjamin Matthew Hatfield, MSW, LICSW, LADC

  • Clinical Social Worker
  • Duluth, MN
National Provider Identifier
1083993299
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20033 Issued in MN
Practice address
1401 E 1St St
Duluth, MN 55805-2407
Phone
(218) 728-4491
Fax
(218) 728-4404
NPI assigned
Aug 5, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 302616 MN
Clinical Social Worker 1041C0700X 20033 MN Primary

Addresses

Primary practice location

1401 E 1St St
Duluth, MN 55805-2407

Mailing address

1401 E 1St St
Duluth, MN 55805-2407
Phone (218) 728-4491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160324001227 MN Practitioner - Clinical Social Worker 1456658103 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
302616MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brightwater Health Dba Human Development Center Addiction (Substance Use Disorder) CurrentSince Feb 22, 2016 Accepting new patients
Brightwater Health Dba Human Development Center Past Accepting new patients
Brightwater Health Dba Human Development Center Past Accepting new patients

Locations

40 11th St
Cloquet, MN 55720
Phone (218) 879-4559

810 E 4th St
Duluth, MN 55805
Phone (218) 728-4491

1401 E 1st St
Duluth, MN 55805
Phone (218) 728-4491

325 11th Ave
Two Harbors, MN 55616
Phone (218) 834-5520

629 1st Ave
Two Harbors, MN 55616
Phone (218) 834-5520

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/humandevelopmentcenter/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1083993299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052407",
            "telephone_number": "218-728-4491",
            "fax_number": "218-728-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052407",
            "telephone_number": "218-728-4491",
            "fax_number": "218-728-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATFIELD",
        "first_name": "BENJAMIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "MSW, LICSW, LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-05",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302616",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.