Hennepin Autism Center Inc

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

HENNEPIN AUTISM CENTER INC

Practice address

405 Cedar Ave S
Minneapolis, MN 55454-1032

Phone

(612) 259-7711

Fax

(612) 545-3760

NPI assigned

Dec 20, 2024

Last updated

Dec 20, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

HENNEPIN AUTISM CENTER INCAs reported in NPPES

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

Authorized official

Name

Suleiman M Isse

Title

Ceo

Phone

(612) 259-7711

Specialties & licenses 2

Addresses

Tax ID family

Hennepin Autism Center Inc2 organizations share this tax ID, including this one

Part of

Hennepin Autism Center Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Hennepin Autism Center Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1275138489
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Hennepin Autism Center Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1275138489
  NPPES parent name

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

{
    "created_epoch": "1734652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734652800000",
    "number": "1144038290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 CEDAR AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541032",
            "telephone_number": "612-286-8091",
            "fax_number": "612-545-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 CEDAR AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541032",
            "telephone_number": "612-259-7711",
            "fax_number": "612-545-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENNEPIN AUTISM CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HENNEPIN AUTISM CENTER INC",
        "enumeration_date": "2024-12-20",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "ISSE",
        "authorized_official_first_name": "SULEIMAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-259-7711"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kris Mallon Hennelly, MSW, LICSW
• Alex Hennen, PHARM.D, BCGP
• Emma Margaret Jindra Hennen, PHARMD
• Stella N.Y.a. Hennen, MD, MSPH
• Hennepin Adult Day Care Services Corp
• Hennepin Autism Center Inc
• Hennepin Care LLC
• Hennepin County
• Hennepin County (Behavioral Health Center)
• Hennepin County

• Early Intervention Provider Agency in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Early Intervention Provider Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.