Individual provider Active NPI

Stephanie A Hruska, LCSW/LICSW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1467121830
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
33904 Issued in MN
Practice address
579 Wells St
Saint Paul, MN 55130-4134
Phone
(651) 793-3803
NPI assigned
Sep 9, 2021
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 182732 AK
Clinical Social Worker 1041C0700X 214326 AK
Clinical Social Worker 1041C0700X 33904 MN Primary

Addresses

Primary practice location

579 Wells St
Saint Paul, MN 55130-4134

Mailing address

579 Wells St
Saint Paul, MN 55130-4134

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
182732AKMDSocial Worker
214326AKMDClinical Social Worker
33904MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1467121830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 WELLS ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551304134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 WELLS ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551304134",
            "telephone_number": "651-793-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRUSKA",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "LCSW/LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AK",
            "license": "182732",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "214326",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "33904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.