Hannah Marie Pederson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2359 Issued in MN

Practice address

815 37TH Ave S
Moorhead, MN 56560-5524

Phone

(701) 451-7811

Fax

(651) 925-0057

NPI assigned

May 15, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Village Family Service Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fargo, ND
  • NPI 1568492353

  Professional

  NPD
• Lake Country Associates, Inc.

  • Community/Behavioral Health Agency
  • Park Rapids, MN
  • NPI 1104151588
  NPD (past)
• Village Family Service Center

  • Substance Abuse Rehabilitation Facility
  • Fargo, ND
  • NPI 1952679318
  NPD (past)

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1326575903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9859",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581069859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 37TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605524",
            "telephone_number": "701-451-7811",
            "fax_number": "651-925-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "HANNAH",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-15",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "02004",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Kay Paul, MA/CCC-SLP
• Michael Dana Paulson, PHD
• Brittany Paulus
• Tausha May Pearson
• William O. Pearson IV, LAMFT
• Kelsi Pederson
• Elizabeth Pelton
• Lisa Marie Peralta Sullivan
• Sarah Perez-Hernandez
• Macey Jean Perius

• Professional Counselor in Moorhead, MN
• Providers in Moorhead, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.