Individual provider Active NPI

Hallie Costello

  • Clinical Social Worker
  • Faribault, MN
National Provider Identifier
1881345379
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
410 Central Ave N
Faribault, MN 55021-5217
Phone
(507) 446-0431
NPI assigned
Jan 16, 2022
Last updated
Mar 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 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 NU Primary

Addresses

Primary practice location

410 Central Ave N
Faribault, MN 55021-5217

Mailing address

10567 165TH St W
Lakeville, MN 55044-3523
Phone (952) 767-9374

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
I20221221001560 MN Practitioner - Clinical Social Worker 8527438258 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mears Psychological LLC CurrentSince Apr 27, 2025 Accepting new patients
Fernbrook Family Center, Inc PastSince Jan 26, 2022 Accepting new patients
Fernbrook Family Center Past Accepting new patients
Healthy Balance Psychology, LLC PastSince Apr 27, 2025 Accepting new patients

Locations

220 Central Ave N
Ste 100
Faribault, MN 55021
Phone (507) 475-4721

10567 165th St W
Lakeville, MN 55044
Phone (952) 767-9374

150 Saint Andrews Dr
Ste 120
Mankato, MN 56001
Phone 9527679374 ext. 79374

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1642291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1881345379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10567 165TH ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443523",
            "telephone_number": "952-767-9374",
            "fax_number": "855-538-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CENTRAL AVE N",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215217",
            "telephone_number": "507-446-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "HALLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-16",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Faribault, MN

Sources for this page

Verify at the official NPI Registry.