Individual provider Active NPI

Joy Hanna Cloutier, PHMNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Andover, MN
National Provider Identifier
1124882519
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11261 Issued in MN
Practice address
1714 Bunker Lake Blvd NW Ste 108
Andover, MN 55304-4091
Phone
(763) 330-2839
NPI assigned
Feb 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11261 MN Primary

Addresses

Primary practice location

1714 Bunker Lake Blvd NW Ste 108
Andover, MN 55304-4091

Mailing address

1714 Bunker Lake Blvd NW Ste 108
Andover, MN 55304-4091
Phone (763) 330-2839

Other practice location 1

12708 Quaker Ln N
Champlin, MN 55316-1295
Phone (763) 742-0372

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240318000528 MN Practitioner - Nurse Practitioner 0547607244 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Innovations IncGroup PAC ID 6204178528, 96 clinicians

Practice addresses (Care Compare)

1833 3Rd Ave
Anoka, MN 55303-2424
Phone (763) 421-5535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11261MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Feb 26, 2024 Accepting new patients
Transformation House Inc CurrentSince Jul 1, 2024 Accepting new patients
Transformation House, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Family Support Services Inc. PastSince May 30, 2023 Accepting new patients

Locations

1714 Bunker Lake Blvd NW
Ste 100
Andover, MN 55304
Phone (763) 330-2830

1714 Bunker Lake Blvd NW
Ste 108
Andover, MN 55304
Phone (763) 330-2830

1410 S Ferry Rd
Anoka, MN 55303
Phone (763) 427-7155

10729 Town Square Dr NE
Ste 120
Blaine, MN 55449
Phone (763) 200-8248

13045 Falcon Dr
#100
Brainerd, MN 56425
Phone (218) 203-6282

817 Main St N
Cambridge, MN 55008
Phone (763) 325-0300

11660 Round Lake Blvd NW
Coon Rapids, MN 55433
Phone (763) 317-0718

9245 Quantrelle Ave NE
Otsego, MN 55330
Phone (763) 308-8619

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

101 Dehler Dr
Sartell, MN 56377
Phone (320) 253-3512

Organizations & group practices 5

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": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1124882519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 BUNKER LAKE BLVD NW STE 108",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553044091",
            "telephone_number": "763-330-2839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 BUNKER LAKE BLVD NW STE 108",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553044091",
            "telephone_number": "763-330-2839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12708 Quaker Ln N",
            "address_purpose": "LOCATION",
            "city": "Champlin",
            "state": "MN",
            "postal_code": "553161295",
            "country_code": "US",
            "telephone_number": "763-742-0372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLOUTIER",
        "first_name": "JOY",
        "middle_name": "HANNA",
        "credential": "PHMNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "11261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MN

Sources for this page

Verify at the official NPI Registry.