NPIMap

Organization Active NPI

Hamm Memorial Psychiatric Clinic

Doing business as Hamm Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
National Provider Identifier
1609876051
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
800960-1-MHC Issued in MN
Legal business name
HAMM MEMORIAL PSYCHIATRIC CLINIC
Doing business as
Hamm Clinic
Practice address
408 Saint Peter St
Ste 429
Saint Paul, MN 55102-1130
Phone
(651) 224-0614
Fax
(651) 224-5754
NPI assigned
Jul 28, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Mary Ellen Jaehne, LICSWNPI 1659370831
Title
Clinical Director
Phone
(651) 224-0614

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 800960-1-MHC MN Primary

Addresses

Primary practice location

408 Saint Peter St
Ste 429
Saint Paul, MN 55102-1130

Mailing address

408 Saint Peter St
Ste 429
Saint Paul, MN 55102-1130
Phone (651) 224-0614

Other identifiers 1

IdentifierTypeStateIssuer
23328HAOtherBC/BS

Other names 1

  • Hamm Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050218000177 MN Part B Supplier - Clinic/Group Practice 8426000340 Receives reassigned benefits from 23 practitioners
Practice locations: Saint Paul, MN

National Provider Directory

National Provider Directory
Tax ID family
Hamm Memorial Psych Cli2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10 River Park Plz
Ste 710
Saint Paul, MN 55107
Phone (651) 224-0614

408 Saint Peter St
Ste 429
Saint Paul, MN 55102
Phone (651) 224-0614

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609876051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 SAINT PETER ST",
            "address_2": "STE 429",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021130",
            "telephone_number": "651-224-0614",
            "fax_number": "651-224-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 SAINT PETER ST",
            "address_2": "STE 429",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021130",
            "telephone_number": "651-224-0614",
            "fax_number": "651-224-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMM MEMORIAL PSYCHIATRIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JAEHNE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "651-224-0614",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MN",
            "license": "800960-1-MHC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "23328HA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hamm Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.