Traci Lyn Hakanson, LISCW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

15625 Issued in MN

Practice address

301 Fuller St S
Shakopee, MN 55379-1322

Phone

(612) 280-3048

NPI assigned

Mar 1, 2007

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

Other names 1

• Traci Lyn Weise 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

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of ScottGroup PAC ID 4587605225, 11 clinicians

Practice addresses (Care Compare)

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.

• County of Scott

  • Psychologist
  • Shakopee, MN
  • NPI 1841299443
  Medicare reassignment Care Compare group NPD
• Canvas Health, Inc.

  • Mental Health Counselor
  • Oakdale, MN
  • NPI 1922051325
  Medicare reassignment NPD
• County of Scott

  • Public Health or Welfare Agency
  • Shakopee, MN
  • NPI 1821156183
  NPD
• Heartfelt Therapy LLC

  • Community/Behavioral Health Agency
  • Lakeville, MN
  • NPI 1740653575
  NPD

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1225166135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17439 ISLETON AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449693",
            "telephone_number": "612-280-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 FULLER ST S",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791322",
            "telephone_number": "612-280-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKANSON",
        "first_name": "TRACI",
        "middle_name": "LYN",
        "credential": "LISCW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9015-123",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "15625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "WEISE",
            "middle_name": "LYN",
            "credential": "MS, LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brooklyn Grace Gunnare, PA-C
• Yelena Y Gura
• Zeytun Mohamed Guyo, MD
• Kristen Marie Hager, D.C.
• Robert Frederick Hagerstrom
• Mark Halbkat
• Jessica Haller-Chew, OT
• Batsheva Halpert, LICSW
• Michelle Lynn Hammerschmidt, L.AC.
• Mark Hanson

• Social Worker in Shakopee, MN
• Providers in Shakopee, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.
• 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.