Individual provider Active NPI

Hannah Jo Van Otterloo, LGSW

  • Clinical Social Worker
  • Mankato, MN
National Provider Identifier
1093631244
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
32916 Issued in MN
Practice address
1600 Madison Ave Ste 110
Mankato, MN 56001-5820
Phone
(651) 313-8080
Fax
(651) 925-0610
NPI assigned
Jun 24, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 32916 MN Primary

Addresses

Primary practice location

1600 Madison Ave Ste 110
Mankato, MN 56001-5820

Mailing address

2182 Eagle Ridge Dr
North Mankato, MN 56003-1232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1782259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1093631244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2182 EAGLE RIDGE DR",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560031232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MADISON AVE STE 110",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015820",
            "telephone_number": "651-313-8080",
            "fax_number": "651-925-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN OTTERLOO",
        "first_name": "HANNAH",
        "middle_name": "JO",
        "credential": "LGSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-24",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "32916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.