Individual provider Active NPI

Paula Elizabeth Noonan, MS, MSW

  • Mental Health Counselor
  • Waconia, MN
National Provider Identifier
1770345316
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1309 Oak Ave Ste 208
Waconia, MN 55387-1080
Phone
(612) 242-0417
NPI assigned
Jan 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 28596 MN
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1309 Oak Ave Ste 208
Waconia, MN 55387-1080

Mailing address

8640 Eagle Creek Cir
Savage, MN 55378-4400
Phone (952) 746-7664

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
I20240326003435 MN Practitioner - Clinical Social Worker 2567809551 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Psychological Services, P.C. Mental Health CurrentSince Mar 2, 2026 Accepting new patients
River Valley Behavioral Health & Wellness Center, PLLC CurrentSince Feb 9, 2024 Accepting new patients
River Valley Behavioral Health & Wellness Center, PLLC Mental Health PastSince Feb 4, 2024 Accepting new patients

Locations

7401 Metro Blvd
Ste 525
Minneapolis, MN 55439

3400 1st St N
Ste 101
Saint Cloud, MN 56303
Phone (320) 202-2000

7551 9th St N
Ste 100
Saint Paul, MN 55128
Phone (651) 747-4328

8640 Eagle Creek Cir
Savage, MN 55378
Phone (952) 746-7664

1309 Oak Ave
Ste 208
Waconia, MN 55387
Phone (612) 242-0417

Organizations & group practices 3

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": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1770345316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8640 EAGLE CREEK CIR",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553784400",
            "telephone_number": "952-746-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 OAK AVE STE 208",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871080",
            "telephone_number": "612-242-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "PAULA",
        "middle_name": "ELIZABETH",
        "credential": "MS, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28596",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.