Hailey Woodstrom

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC04616 Issued in MN

Practice address

895 Fuller Ave
Saint Paul, MN 55104-4742

Phone

(218) 849-5511

NPI assigned

Jun 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Minnesota Center for Psychology, LLC

  • Psychologist
  • Saint Paul, MN
  • NPI 1023258662
  Medicare reassignment NPD

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1205402278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 FULLER AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044742",
            "telephone_number": "218-849-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 FULLER AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044742",
            "telephone_number": "218-849-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5407 Excelsior Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554162932",
            "country_code": "US",
            "telephone_number": "612-787-2832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODSTROM",
        "first_name": "HAILEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC04616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Lee Wood
• Woodbury Dental Care
• Kathryn Sylvia Woodhouse
• Emilia Violetta Woods
• Sophia Woods, MS, BCBA, LBA
• Laura Halley Woodward
• Trinity Love Woolery, MSW, LICSW, LADC
• Johnathan Woolheater
• Stanley A Woolner, M.D.
• Sandra J. Woolsey, M.A. LPCC

• Professional Counselor in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.