Medora Mental Health and Consulting, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MEDORA MENTAL HEALTH AND CONSULTING, PLLC

Practice address

6 E 45TH St
Minneapolis, MN 55419-5026

Phone

(773) 968-0227

NPI assigned

Oct 24, 2021

Organization subpart

No

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

Authorized official

Name

Elizabeth HansonNPI 1427609031

Title

Owner

Phone

(773) 968-0227

Specialties & licenses 1

Addresses

Other names 1

• Medora Mental Health and Consulting Other name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth Hanson, MSW, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1427609031
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1635033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1992469290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3613 COLUMBUS AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554072528",
            "telephone_number": "773-968-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 E 45TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195026",
            "telephone_number": "773-968-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDORA MENTAL HEALTH AND CONSULTING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-24",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-968-0227"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medora Mental Health and Consulting",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Medora Mental Health and Consulting",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Perla J Medina Rodriguez
• Eduardo Miguel Medina, M.D.,M.P.H.
• Jacqueline Medina, DDS
• Janet Medley-Gbassa
• Susan A Medo, MA LP
• Medstar Home Services LLC
• Medtech LLC
• Medtech Supplies Services
• Medtronic USA
• Donna Medved, RN

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.