DR. SANDRA SUE SMITH HANEN (EDD) – Psychologist, NPI 1750480679

DR. SANDRA SUE SMITH HANEN (EDD) is a healthcare provider. based in Minneapolis, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials EDD. They hold a License No. LP2754 (MN). The NPI Number for DR. SANDRA SUE SMITH HANEN (EDD) is 1750480679

Main info

Female
50 Years Of Experience
Accepts Medicare Assignment
Name
DR. SANDRA SUE SMITH HANEN (EDD)
NPI
1750480679
Phone
(612) 722-1003
Address
4323 E LAKE ST
Enumeration Date
21 September 2006
Last Update Date
12 March 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6127221003
Graduation Year
1976 (50 years ago)
PAC ID
8820037229
Group Practice PAC ID
3173749322
Professional Enrollment ID
I20050426000501
Address ID
MN554062307MI4323XSTXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

Loading map...

Provider Addresses for DR. SANDRA SUE SMITH HANEN (EDD)

  • 4323, East Lake Street, Cooper, Longfellow, Minneapolis, Hennepin County, Minnesota, 55406, United States

    MINNEAPOLIS, MN 554062307

    Phone: (612) 722-1003

    Fax: (612) 721-6336

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2005-04-26

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
I20050426000501IClinical 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes16013$0
View full utilization report →

Insurance plans in this area (ZIP 55406)

Loading plans...

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: 3173749322View full group profile

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I use this page to confirm DR. SANDRA SUE SMITH HANEN (EDD)'s NPI?
Yes. DR. SANDRA SUE SMITH HANEN (EDD) is listed with NPI 1750480679 in the public NPI dataset.
Is DR. SANDRA SUE SMITH HANEN (EDD) listed as active for patients and plans?
The listing shows DR. SANDRA SUE SMITH HANEN (EDD) as active in the NPI system.
What healthcare role does DR. SANDRA SUE SMITH HANEN (EDD) hold?
Scheduling teams often label DR. SANDRA SUE SMITH HANEN (EDD) under Psychologist. Clinical services aligned with this taxonomy classification.
Where is DR. SANDRA SUE SMITH HANEN (EDD) based?
DR. SANDRA SUE SMITH HANEN (EDD) is tied to Minneapolis, Minnesota in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

Similar Providers

3332, 21st Avenue South, Corcoran, Nokomis, Minneapolis, Hennepin County, Minnesota, 55407, United States
NPI: 1720084502
5501, Mount Normandale Drive, Bloomington, Hennepin County, Minnesota, 55437, United States
NPI: 1235138447
Harriet Av, West Franklin Avenue, Whittier, Minneapolis, Hennepin County, Minnesota, 55405, United States
NPI: 1215938659

DIXIE LEE GRACE (PH.D.)

Clinical Psychologist
5th Street, Morris Park, Minneapolis, Hennepin County, Minnesota, 55111, United States
NPI: 1932191889
431, South 7th Street, Minneapolis, Hennepin County, Minnesota, 55415, United States
NPI: 1104813716

DR. WINIFRED LILLY-TAYLOR (PHD, LP)

Marriage & Family Therapist
2415, Cromwell Drive, Fulton, Southwest, Minneapolis, Hennepin County, Minnesota, 55410, United States
NPI: 1356323182
Wayzata Boulevard, Blackstone, Saint Louis Park, Hennepin County, Minnesota, 55416, United States
NPI: 1265415707

TERESA PLUMMER

Psychologist
Wayzata Boulevard, Blackstone, Saint Louis Park, Hennepin County, Minnesota, 55416, United States
NPI: 1770567455

AMANDA HYATT

Psychologist
33rd Avenue South, Wenonah, Minneapolis, Hennepin County, Minnesota, 55417, United States
NPI: 1750366746