JOAN GUDORF LICSW
NPI 1508664269
Clinic/Center - Mental Health (Including Community Mental Health Center) in Edina, MN

Q: What is Joan Gudorf Licsw's NPI number?

The NPI number for Joan Gudorf Licsw is 1508664269. It was assigned to this organization in the NPPES registry on March 6, 2025.

Q: What is Joan Gudorf Licsw's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Q: When was this NPI record last updated?

The NPPES record for Joan Gudorf Licsw was last updated on December 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.

Active since March 06, 2025

4530 77TH ST W STE 325, EDINA, MN 55435(612) 554-5095 Get Directions Write a Review

NPPES record last updated: December 11, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 11, 2025, Mar 6, 2025 (2 updates tracked since 2025).

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About Joan Gudorf Licsw NPPES

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

JOAN GUDORF LICSW (NPI 1508664269) is a healthcare organization registered as a mental health (including community mental health center) in Edina, Minnesota and active in the NPI registry since March 2025. The organization lists Joan Gudorf, Owner/licensed Social Worker, as its authorized official.

NPPES Registry Identity

NPI1508664269

Entity TypeOrganization

Primary Taxonomy261QM0801X

Legal Business NameJOAN GUDORF LICSW

Location Address4530 77TH ST W STE 325Edina, MN 55435-5012

Mailing Address4808 Wilford WayEdina, MN 55435-1563 · (612) 554-5095

Phone(612) 554-5095

Organization SubpartNo

Authorized OfficialJoan GudorfOwner/licensed Social Worker · (612) 555-5095

Enumeration DateMarch 6, 2025

Last NPPES UpdateDecember 11, 20252 updates tracked since enumeration

NPPES CertifiedDecember 11, 2025

✔ NPI 1508664269 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities

Taxonomy Code261QM0801X

4530 77TH ST W STE 325, Edina, MN 55435

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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 and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Joan Gudorf Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Joan Gudorf Licsw, which bills Medicare for the services this clinician delivers.

Clinician (1)

Joan Gudorf, LICSW

Clinical Social Worker

NPI 1114617305

750 2ND ST NE STE 218
Hopkins, MN 55343

(651) 317-9659

✔ PECOS✔ Accepts Medicare5.1 mi

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

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 Joan Gudorf Licsw's NPI number?

The NPI number for Joan Gudorf Licsw is 1508664269. It was assigned to this organization in the NPPES registry on March 6, 2025.

Where is Joan Gudorf Licsw located?

Joan Gudorf Licsw is located at 4530 77th St W Ste 325, Edina, MN 55435. The listed phone number is (612) 554-5095.

What is Joan Gudorf Licsw's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Is Joan Gudorf Licsw enrolled in Medicare?

Yes. Joan Gudorf Licsw is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Joan Gudorf Licsw?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Joan Gudorf Licsw. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Joan Gudorf Licsw accept?

Health plans from HealthPartners list Joan Gudorf Licsw 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 Joan Gudorf Licsw was last updated on December 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.