Jacquelyn Kaye Hanson-Hietala, LGSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

26768 Issued in MN

Practice address

205 W 2ND St Ste 300
Duluth, MN 55802-1928

Phone

(218) 590-1178

Fax

(218) 481-7405

NPI assigned

Feb 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: jacquelyn.hanson-hietala@whiteearth-nsn.gov

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1215569181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 SHADY LN",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558119732",
            "telephone_number": "218-590-1178",
            "fax_number": "218-481-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W 2ND ST STE 300",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021928",
            "telephone_number": "218-590-1178",
            "fax_number": "218-481-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON-HIETALA",
        "first_name": "JACQUELYN",
        "middle_name": "KAYE",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jacquelyn.hanson-hietala@whiteearth-nsn.gov",
            "affiliation": "N",
            "endpointDescription": "205 W 2nd Street Suite 300",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Duluth",
            "address_1": "205 W 2nd St Ste 300",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558021928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jason John Hansen, DO
• Jennifer Lynn Hansen, APRN, CNP
• Lindsay Rae Hansen
• Steven J. Hansen, MD
• Todd Hansen, DDS
• Anna Karmae Hanson, PHARMD
• Brent Hanson, MSN, CNP, PMHNP-BC
• Catherine Hanson, OTR
• David Carl Hanson, MD
• Eric John Hanson, DPT

• Clinical Social Worker in Duluth, MN
• Providers in Duluth, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.