Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Angela Hasouris

Individual provider Clinical Social Worker · NPI 1508634379

Angela Hasouris is a Clinical Social Worker in Maple Grove, Minnesota. Qualified in 2022, 4 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

9600 Upland Ln N Ste 110
Maple Grove, MN 55369-4499
Phone: (952) 993-6200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5354 Parkdale Dr, St Louis Park, MN 55416-1603 — (888) 364-5977

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 31115 (MN)
Clinical Social Worker Taxonomy 1041C0700X · Licence 31115 (MN)

Record details

NPI number1508634379
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 12, 2023
Last updated in NPPESJanuary 9, 2025
Certification dateJanuary 9, 2025
Mailing address8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425-4516

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Maple Grove