Active NPI
Sue Ann Stewart, CFPS
- Peer Specialist
- Hackensack, MN
National Provider Identifier
1780248807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 112 Highway 371 S
Hackensack, MN 56452-2638 - Phone
- (218) 675-5101
- NPI assigned
- Apr 24, 2019
- Last updated
- Apr 24, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | NU | Primary |
Addresses
Primary practice location
112 Highway 371 S
Hackensack, MN 56452-2638
Mailing address
317 28TH Ave NW
Backus, MN 56435-2322
Phone (218) 587-2285
Other practice location 1
112 Highway 371 S
Hackensack, MN 56452-2638
Phone (218) 675-5101
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Birch Lake Counseling LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinic/Center
- Hackensack, MN
- NPI 1760646715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556064000000",
"number": "1780248807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "317 28TH AVE NW",
"city": "BACKUS",
"state": "MN",
"postal_code": "564352322",
"telephone_number": "218-587-2285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 HIGHWAY 371 S",
"city": "HACKENSACK",
"state": "MN",
"postal_code": "564522638",
"telephone_number": "218-675-5101"
}
],
"practiceLocations": [
{
"address_1": "112 Highway 371 S",
"address_purpose": "LOCATION",
"city": "Hackensack",
"state": "MN",
"postal_code": "564522638",
"country_code": "US",
"telephone_number": "218-675-5101",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STEWART",
"first_name": "SUE",
"middle_name": "ANN",
"credential": "CFPS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-24",
"last_updated": "2019-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hackensack, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.