Individual provider Active NPI

Hanna Marie Schaefer, LICSW

  • Clinical Social Worker
  • Brooklyn Center, MN
National Provider Identifier
1205672706
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
6040 Earle Brown Dr
Brooklyn Center, MN 55430-2514
Phone
(612) 568-8455
NPI assigned
Jul 3, 2024
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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 NU Primary

Addresses

Primary practice location

6040 Earle Brown Dr
Brooklyn Center, MN 55430-2514

Mailing address

6040 Earle Brown Dr
Brooklyn Center, MN 55430-2514

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
I20240821004922 MN Practitioner - Clinical Social Worker 1759820749

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD Clinical CurrentSince Mar 14, 2026 Accepting new patients

Locations

1370 Mendota Heights Rd
Mendota Heights, MN 55120
Phone (651) 764-7245

6040 Earle Brown Dr
Ste 100
Minneapolis, MN 55430
Phone (612) 470-4576

1150 Montreal Ave
Ste 107
Saint Paul, MN 55116
Phone (651) 307-5148

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1205672706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 EARLE BROWN DR",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 EARLE BROWN DR",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302514",
            "telephone_number": "612-568-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "HANNA",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Center, MN

Sources for this page

Verify at the official NPI Registry.