Individual provider Active NPI

Zackary Hajj-Ali

  • Mental Health Counselor
  • Bloomington, MN
National Provider Identifier
1609554179
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1801 American Blvd E
Bloomington, MN 55425-1232
Phone
(952) 767-2267
NPI assigned
Jul 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1801 American Blvd E
Bloomington, MN 55425-1232

Mailing address

52 Territorial Rd NE
Blaine, MN 55434-1537
Phone (763) 647-9077

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240102001423 MN Practitioner - Mental Health Counselor 0648620781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fraser Child and Family CenterGroup PAC ID 3971918772, 54 clinicians

Practice addresses (Care Compare)

2400 W 64TH St
Richfield, MN 55423-1001
Phone (612) 861-1688

9120 Springbrook Dr NW
Coon Rapids, MN 55433-5845
Phone (612) 767-7222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fraser PastSince Jul 9, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1609554179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 TERRITORIAL RD NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554341537",
            "telephone_number": "763-647-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251232",
            "telephone_number": "952-767-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAJJ-ALI",
        "first_name": "ZACKARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.