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ELIZA WOODWARD HARTLEY
NPI 1215671557
Counselor in Mendota Heights, MN

Active since April 22, 2022PECOS Enrolled
1155 NORTHLAND DR, MENDOTA HEIGHTS, MN 55120(612) 223-8898 Get Directions Write a Review

NPPES record last updated: April 20, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Eliza Woodward Hartley NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELIZA WOODWARD HARTLEY (NPI 1215671557) is an individual counselor in Mendota Heights, Minnesota and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1215671557
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameELIZA WOODWARD HARTLEY
Location Address1155 NORTHLAND DRMendota Heights, MN 55120-1288
Mailing Address5 Sparrow LnNorth Oaks, MN 55127-6453 · (651) 492-4770
Phone(612) 223-8898
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateApril 22, 2022
Last NPPES UpdateApril 20, 2023
NPPES CertifiedApril 20, 2023
✔ NPI 1215671557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
1155 NORTHLAND DR, Mendota Heights, MN 55120
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eliza Woodward Hartley is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9739601303
PECOS Enrollment IDI20250324002434
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Eliza Hartley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grander Peace Counseling LLC
5.3 mi
Community/Behavioral Health
658 GRAND AVE STE 201
Saint Paul, MN 55105
  • Reassigned Medicare billing, Minnesota enrollment
  • 16 clinicians in this Medicare group
NPI 1013486505 (612) 454-1656

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. HANNAH RUTH BEAUCLAIRE MSW, LICSW
Social Worker (Clinical)
1155 NORTHLAND DR
MENDOTA HEIGHTS, MN 55120
Dakota County (651) 285-6455
AUBREY MILLER LPCC
Counselor (Professional)
1155 NORTHLAND DR
MENDOTA HEIGHTS, MN 55120
Dakota County (612) 223-8898
JESSICA RAE STOCK LADC
Counselor (Addiction (Substance Use Disorder))
1155 NORTHLAND DR
MENDOTA HEIGHTS, MN 55120
Dakota County (612) 223-8898
HEIDI BAUSCH-RYAN PSYD, LP
Psychologist
1155 NORTHLAND DR
MENDOTA HEIGHTS, MN 55120
Dakota County (612) 223-8898
JENNA MCKENZIE
Psychologist
1155 NORTHLAND DR
MENDOTA HEIGHTS, MN 55120
Dakota County (763) 330-9225
HANNAH LORRAINE ERICKSON LPCC
Counselor (Professional)
1155 NORTHLAND DR
MENDOTA HEIGHTS, MN 55120
Dakota County (612) 223-8898
MS. JOSEPHINE ROSE ETOLL-NEVEU MA
Counselor (Mental Health)
1155 NORTHLAND DR
MENDOTA HEIGHTS, MN 55120
Dakota County (612) 223-8898
DR. AMY CARRISON LP, LADC
Psychologist
1155 NORTHLAND DR
MENDOTA HEIGHTS, MN 55120
Dakota County (612) 223-9989

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eliza Hartley's NPI number?

The NPI number for Eliza Hartley is 1215671557. It was assigned to this individual provider in the NPPES registry on April 22, 2022.

Where is Eliza Hartley located?

Eliza Hartley practices at 1155 Northland Dr, Mendota Heights, MN 55120. The listed phone number is (612) 223-8898.

What is Eliza Hartley's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Eliza Hartley enrolled in Medicare?

Yes. Eliza Hartley is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Eliza Hartley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Eliza Hartley reassigns Medicare benefits to Grander Peace Counseling LLC (Saint Paul, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Eliza Hartley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Eliza Hartley accept?

Health plans from HealthPartners list Eliza Hartley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Eliza Hartley was last updated on April 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.