Eliza Woodward Hartley

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1155 Northland Dr
Mendota Heights, MN 55120-1288

Phone

(612) 223-8898

NPI assigned

Apr 22, 2022

Last updated

Apr 20, 2023By the provider in NPPES

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Grander Peace Counseling LLCGroup PAC ID 6204173362, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grander Peace Counseling LLC

  • Community/Behavioral Health Agency
  • Saint Paul, MN
  • NPI 1013486505
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1215671557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SPARROW LN",
            "city": "NORTH OAKS",
            "state": "MN",
            "postal_code": "551276453",
            "telephone_number": "651-492-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 NORTHLAND DR",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201288",
            "telephone_number": "612-223-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLEY",
        "first_name": "ELIZA",
        "middle_name": "WOODWARD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-22",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Kathleen Hanson
• Ally Rae Harlander
• Shanley Marie Harper, OTR/L
• Katharine Emelia Harpstead
• Joshua Harrod
• Cole Hartman
• Ayan Abdi Hassan
• Jaafar Alinur Hassan
• Hanna Hailu Hatte
• Health Innovations of America

• Counselor in Mendota Heights, MN
• Providers in Mendota Heights, MN by specialty
• Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.