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

Dr. Sandra Sue Smith Hanen, EDD

Individual provider Psychologist · NPI 1750480679

Dr. Sandra Sue Smith Hanen, EDD is a Clinical Psychologist in Minneapolis, Minnesota. Qualified in 1976, 50 years ago. Practices with River Lake Clinic LLC, a 3-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
50
Licensed in
MN
In the registry since
2006
Specialties on file
6
What do these letters mean?
EDD — Doctor of Education
A doctorate in education.

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Practice location Address checks out

4323 E Lake St
Minneapolis, MN 55406-2307
Phone: (612) 722-1003
Fax: (612) 721-6336
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence LP2754 (MN)
Forensic Psychologist Taxonomy 103TF0200X · Licence LP2754 (MN)
Cognitive & Behavioral Psychologist Taxonomy 103TB0200X · Licence LP2754 (MN)
Counseling Psychologist Taxonomy 103TC1900X · Licence LP2754 (MN)
Adult Development & Aging Psychologist Taxonomy 103TA0700X · Licence LP2754 (MN)
Family Psychologist Taxonomy 103TF0000X · Licence LP2754 (MN)

Record details

NPI number1750480679
Entity typeIndividual (Type 1)
GenderFemale
Credentials EDD
Sole proprietorNo
NPI enumeratedSeptember 21, 2006
Last updated in NPPESMarch 12, 2014

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1976 (50 years in practice)
Group practice River Lake Clinic Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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