Individual provider Active NPI

Hannah Ruth Beauclaire, MSW, LICSW

  • Clinical Social Worker
  • Mendota Heights, MN
National Provider Identifier
1114617859
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
32803 Issued in MN
Practice address
1155 Northland Dr
Mendota Heights, MN 55120-1288
Phone
(651) 285-6455
NPI assigned
May 8, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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 32803 MN Primary

Addresses

Primary practice location

1155 Northland Dr
Mendota Heights, MN 55120-1288

Mailing address

1155 Northland Dr
Mendota Heights, MN 55120-1288
Phone (612) 223-8898

Other names 1

  • Mrs. Hannah Ruth Beauclaire Professional name

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
I20250930000056 MN Practitioner - Clinical Social Worker 0749786721

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Optum Cir
Eden Prairie, MN 55344-2956

7601 Wayzata Blvd
Saint Louis Park, MN 55426-1623

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Colorado, P.C. Current Accepting new patients
Optum Behavioral Care of Colorado, P.C. Clinical CurrentSince Aug 13, 2025 Accepting new patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Aug 13, 2025 Accepting new patients

Locations

7400 W 109th St
Bloomington, MN 55438
Phone (952) 886-3268

1155 Northland Dr
Saint Paul, MN 55120
Phone (612) 223-8899

7601 Wayzata Blvd
St Louis Park, MN 55426
Phone (612) 223-8899

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": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1114617859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 NORTHLAND DR",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201288",
            "telephone_number": "612-223-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 NORTHLAND DR",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201288",
            "telephone_number": "651-285-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUCLAIRE",
        "first_name": "HANNAH",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "32803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "BEAUCLAIRE",
            "middle_name": "RUTH",
            "prefix": "MRS.",
            "credential": "MSW, LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Mendota Heights, MN

Sources for this page

Verify at the official NPI Registry.