Hannah Mae Kidder, LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4470 Issued in MN

Practice address

6040 Earle Brown Dr Ste 100
Brooklyn Center, MN 55430-2561

Phone

(651) 313-8080

NPI assigned

Oct 27, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Hannah Mae Forney Former name

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.

• Through Therapy Collective, Inc

  • Marriage & Family Therapist
  • Minneapolis, MN
  • NPI 1508324336

  MN, Single Specialty

  Medicare reassignment NPD
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188

  Single Specialty

  NPD

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1215537477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 MENDOTA HEIGHTS RD",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201281",
            "telephone_number": "651-313-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 EARLE BROWN DR STE 100",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302561",
            "telephone_number": "651-313-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDDER",
        "first_name": "HANNAH",
        "middle_name": "MAE",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "4470",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303758",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "FORNEY",
            "middle_name": "MAE",
            "credential": "LADC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashpal S Kent, D.C.
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• Judith Ann Kesty
• Allison Renae Key, MSM, PA-C
• Abrar Khan, M.D.
• Kidney Specialists of Minnesota, PA
• Thea S Killeen
• Robert S Kim, M.D.
• Da'Shuna S King
• Warren R. King, D.C.

• All providers in Brooklyn Center, MN
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.