Individual provider Active NPI

Adam Palowski, LPCC

  • Mental Health Counselor
  • Coon Rapids, MN
National Provider Identifier
1073081535
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1970 Issued in MN
Practice address
10077 Dogwood St NW
Coon Rapids, MN 55448-5286
Phone
(612) 676-1604
NPI assigned
Nov 2, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1970 MN Primary

Addresses

Primary practice location

10077 Dogwood St NW
Coon Rapids, MN 55448-5286

Mailing address

38780 8TH Ave
North Branch, MN 55056-6696

Other practice location 1

38780 8th Ave
North Branch, MN 55056-6696
Phone (701) 212-2189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240304002614 MN Practitioner - Mental Health Counselor 3072958727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Canvas Health IncGroup PAC ID 8729073978, 28 clinicians

Practice addresses (Care Compare)

7066 Stillwater N Blvd
Oakdale, MN 55128-3937
Phone (651) 777-5222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1970MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Canvas Health, Inc. Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

7066 Stillwater Blvd N
Saint Paul, MN 55128

375 Orleans St E
Stillwater, MN 55082
Phone (651) 430-2720

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1073081535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38780 8TH AVE",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550566696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10077 DOGWOOD ST NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554485286",
            "telephone_number": "612-676-1604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38780 8th Ave",
            "address_purpose": "LOCATION",
            "city": "North Branch",
            "state": "MN",
            "postal_code": "550566696",
            "country_code": "US",
            "telephone_number": "701-212-2189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALOWSKI",
        "first_name": "ADAM",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-02",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "1970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.