Kenneth Longfellow Hanna II, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13493 Issued in MN

Practice address

807 Division St S
Northfield, MN 55057-2430

Phone

(320) 420-1272

Fax

(320) 240-6814

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

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.

• Lion Youth & Community Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Northfield, MN
  • NPI 1902302722
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1295812105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 DIVISION ST S",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572430",
            "telephone_number": "320-420-1272",
            "fax_number": "320-240-6814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 DIVISION ST S",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572430",
            "telephone_number": "320-420-1272",
            "fax_number": "320-240-6814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "KENNETH",
        "middle_name": "LONGFELLOW",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Henry Hagen, ATC
• David Kenneth Hakes, O.D.
• Madeline E Halberg, FNP-C
• Craig Robert Hall, CRNA
• Courtney Ham, LADC
• Jill S Hansen, NP
• Shelley Kay Hansen, LSW, MA, LP
• Peggy Hanson, PSYD
• Kathleen A Harrington, LICSW
• Jennifer Harris, LADC, LPCC

• Clinical Social Worker in Northfield, MN
• Providers in Northfield, 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 5, 2025; 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.