Active NPI
Elizabeth Haag, MS, OTR/L
- Occupational Therapist
- Chaska, MN
National Provider Identifier
1295128684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 104805
- Practice address
- 1354 Prairie St
Chaska, MN 55318-2418 - Phone
- (605) 359-7315
- NPI assigned
- Mar 10, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Occupational Therapist | 225XM0800X | |||
| Occupational Therapist | 225X00000X | 104805 | MN | Primary |
Addresses
Primary practice location
1354 Prairie St
Chaska, MN 55318-2418
Mailing address
1354 Prairie St
Chaska, MN 55318-2418
Phone (605) 359-7315
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104805 | Other | MN | MINNESOTA STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678492800000",
"number": "1295128684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1354 PRAIRIE ST",
"city": "CHASKA",
"state": "MN",
"postal_code": "553182418",
"telephone_number": "605-359-7315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1354 PRAIRIE ST",
"city": "CHASKA",
"state": "MN",
"postal_code": "553182418",
"telephone_number": "605-359-7315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAAG",
"first_name": "ELIZABETH",
"credential": "MS, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-10",
"last_updated": "2023-03-11",
"certification_date": "2023-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225XM0800X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "104805",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MINNESOTA STATE LICENSE",
"identifier": "104805",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chaska, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.