DR. EMMANUELLE HANSEN (PSYD) – Clinical Psychologist, NPI 1184200065

DR. EMMANUELLE HANSEN (PSYD) is a healthcare provider. based in Minneapolis, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD. They hold a License No. LP6680 (MN). The NPI Number for DR. EMMANUELLE HANSEN (PSYD) is 1184200065

Main info

Female
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
DR. EMMANUELLE HANSEN (PSYD)
NPI
1184200065
Phone
(612) 223-8898
Address
204 W FRANKLIN AVE
Enumeration Date
22 March 2021
Last Update Date
22 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6514540114
Graduation Year
2018 (8 years ago)
PAC ID
7517366818
Group Practice PAC ID
2860304045
Professional Enrollment ID
I20210518002085
Address ID
MN551232340EA3450XLNXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness85
Years active:5State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

Provider Addresses for DR. EMMANUELLE HANSEN (PSYD)

  • 204 W FRANKLIN AVE

    MINNEAPOLIS, MN 554042331

    Phone: (612) 223-8898

    Type: Location

  • 3625 33RD AVE S

    MINNEAPOLIS, MN 554062726

    Phone: (763) 607-3108

    Type: Mailing

  • 3450 OLEARY LN

    EAGAN, MN 551232340

    Phone: (651) 454-0114

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-05-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210518002085IClinical PsychologistMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55404)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860304045View full group profile
NameSpecialtyState
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical PsychologistMN
Clinical Social WorkerMN
Mental Health CounselorMN
Marriage And Family TherapistMN
-NJ
Mental Health CounselorVA
-MN
Nurse PractitionerMN

Reviews

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Frequently asked questions

Is there an official ID for DR. EMMANUELLE HANSEN (PSYD) in U.S. healthcare records?
The official identifier for DR. EMMANUELLE HANSEN (PSYD) is NPI 1184200065.
Active or inactive — what applies to DR. EMMANUELLE HANSEN (PSYD)?
You should see DR. EMMANUELLE HANSEN (PSYD) as active in CMS-hosted NPPES data.
What expertise is attributed to DR. EMMANUELLE HANSEN (PSYD)?
DR. EMMANUELLE HANSEN (PSYD)'s specialty line reads Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What locale is associated with DR. EMMANUELLE HANSEN (PSYD)?
Directory geography for DR. EMMANUELLE HANSEN (PSYD) centers on Minneapolis, Minnesota.
When was this NPI issued?
Enumeration for DR. EMMANUELLE HANSEN (PSYD) is noted as March 22, 2021 where the registry provides it.

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