Individual provider Active NPI

Summer Hanson, MSW

  • Clinical Social Worker
  • Fargo, ND
National Provider Identifier
1811130529
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3940 Issued in ND
Practice address
1122 2ND St N
Fargo, ND 58102-3737
Phone
(701) 367-6454
NPI assigned
Apr 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3940 ND Primary

Addresses

Primary practice location

1122 2ND St N
Fargo, ND 58102-3737

Mailing address

1122 2ND St N
Fargo, ND 58102-3737
Phone (701) 367-6454

Other practice location 1

2101 Elm St N
Fargo, ND 58102-2417
Phone (701) 239-3700 ext. 94441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: No
  • 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
I20250512000634 ND Practitioner - Clinical Social Worker 7012434202 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3940NDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical of Michigan PC CurrentSince May 1, 2025 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1811130529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 2ND ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023737",
            "telephone_number": "701-367-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 2ND ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023737",
            "telephone_number": "701-367-6454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 Elm St N",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581022417",
            "country_code": "US",
            "telephone_number": "701-239-3700 x94441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSON",
        "first_name": "SUMMER",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-10",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "3940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.