Haley Carlock, DNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP 4630 Issued in MN

Practice address

1155 Ford Rd
Suite B
St Louis Park, MN 55426-1099

Phone

(952) 378-1800

Fax

(952) 378-1714

NPI assigned

May 19, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sonder Behavioral Health and Wellness IncGroup PAC ID 4880987114, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healthwise Psychology, PA

  • Clinical Psychologist
  • Maple Grove, MN
  • NPI 1184920753
  Medicare reassignment NPD
• Sonder Behavioral Health & Wellness, Inc.

  • Clinical Psychologist
  • Minnetonka, MN
  • NPI 1780031732
  Care Compare group
• Medicine Lake Consultation Group,PLLC

  • Psychiatry Physician
  • St Louis Park, MN
  • NPI 1881753564
  NPD
• Scott M Yarosh, LLC

  • Mental Health Counselor
  • Saint Paul, MN
  • NPI 1144543265
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1013364199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 W LAKE ST",
            "address_2": "SUITE 210",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164527",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 FORD RD",
            "address_2": "SUITE B",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261099",
            "telephone_number": "952-378-1800",
            "fax_number": "952-378-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLOCK",
        "first_name": "HALEY",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "CNP 4630",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R 197063-4",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Care Clinics LLC
• Care Clinics, LLC
• Danielle Carey
• Caring Sisters Home Care Services, Inc
• Emma E Carlin, MD
• Karen R Carlsen, LGSW
• Alexander Dale Carlson, MSW, LICSW
• Anders L Carlson, MD
• Blake Carlson, MD
• Erin Carlson

• Psychiatric/Mental Health Nurse Practitioner in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.