Joan Gudorf, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10935 Issued in MN

Practice address

750 2ND St NE Ste 218
Hopkins, MN 55343-8124

Phone

(651) 317-9659

NPI assigned

May 10, 2023

Last updated

May 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Joan Gudorf Licsw

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Edina, MN
  • NPI 1508664269
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1114617305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 WILFORD WAY",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351563",
            "telephone_number": "612-554-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 2ND ST NE STE 218",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553438124",
            "telephone_number": "651-317-9659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDORF",
        "first_name": "JOAN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "10935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Granger, LICSW
• Nathaniel James Gray
• Robert Brady Grider, MS/CCC-SP
• Brian Joseph Grosam, PHD, TCMD, LAC
• Charlotte Louise Groves, LMFT
• Donna Guillory, PHARMD
• Jeffrey Thomas Gullickson, DC
• Amber Marie Hale
• Pamabla Hall
• Shawn Halliday, DC

• Clinical Social Worker in Hopkins, MN
• Providers in Hopkins, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.