Joan Gudorf Licsw
NPI 1508664269 · Mental Health Clinic/Center (Including Community Mental Health Center) · Edina, MN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Joan Gudorf Licsw is a Mental Health Clinic/Center (Including Community Mental Health Center) organization in Edina, MN (NPI 1508664269).
Provider details
- NPI number
- 1508664269
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Joan Gudorf, Owner/Licensed Social Worker(612) 555-5095
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-03-06
- Last updated
- 2025-12-11
- Certified
- 2025-12-11
Frequently asked questions
- What is Joan Gudorf Licsw's NPI number?
- Joan Gudorf Licsw's National Provider Identifier (NPI) is 1508664269, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Joan Gudorf Licsw?
- Joan Gudorf Licsw is classified in the NPPES registry as Mental Health Clinic/Center (Including Community Mental Health Center) (Ambulatory Health Care Facilities).
- Where is Joan Gudorf Licsw located?
- Joan Gudorf Licsw's practice location on file with NPPES is 4530 77th St W Ste 325, Edina, MN 55435-5012.
- What is Joan Gudorf Licsw's phone number?
- The practice phone number listed in the NPPES registry for Joan Gudorf Licsw is (612) 554-5095.
- Does Joan Gudorf Licsw accept Medicare?
- Joan Gudorf Licsw is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Joan Gudorf Licsw?
- The authorized official listed on Joan Gudorf Licsw's NPPES record is Joan Gudorf, Owner/Licensed Social Worker. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Joan Gudorf Licsw's NPI active?
- Yes — Joan Gudorf Licsw's NPI (1508664269) is active in the NPPES registry as of the last update on 2025-12-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.