Traci Lee Hackmann Bates, MA LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP3650 Issued in MN

Practice address

3920 Sibley Memorial Hwy
Eagan, MN 55122-1414

Phone

(651) 681-0616

Fax

(651) 681-0747

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Ms. Traci Lee Hackmann Professional name

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

Specialty

Mental Health Counselor

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sonder Behavioral Health and Wellness IncGroup PAC ID 4880987114, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sonder Behavioral Health & Wellness, Inc.

  • Clinical Psychologist
  • Minnetonka, MN
  • NPI 1780031732
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750491296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4481 PONDVIEW TRL SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722987",
            "telephone_number": "952-440-1578",
            "fax_number": "651-994-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 SIBLEY MEMORIAL HWY",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221414",
            "telephone_number": "651-681-0616",
            "fax_number": "651-681-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKMANN BATES",
        "first_name": "TRACI",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "MA LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "454T7HA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "123175",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "62-64083",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP24216",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "HACKMANN",
            "middle_name": "LEE",
            "prefix": "MS.",
            "credential": "MA LP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Michael H Gurewitz, DDS
• Teresa Louise-Keller Gurin, M.D.
• Patricia Diane Gust, L. AC.
• Isabella Rose Haake, PHARMD
• Alexia Habermann
• Kellie L Haehnel, RMT
• Ashley B Hagen, PA-C
• Dana Marie Hagen, CNM
• Connor Michael Hagerty, D.M.D
• Vincent Hague

• Psychologist in Eagan, MN
• Providers in Eagan, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.