Individual provider Active NPI

Callie Reznick, LMHC, LPCC

  • Professional Counselor
  • Edina, MN
National Provider Identifier
1083180889
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4133 Issued in MN
Practice address
6600 France Ave S
Edina, MN 55435-1805
Phone
(952) 835-2002
Fax
(952) 835-9889
NPI assigned
Oct 18, 2018
Last updated
Jul 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4133 MN Primary

Addresses

Primary practice location

6600 France Ave S
Edina, MN 55435-1805

Mailing address

6600 France Ave S Ste 230
Edina, MN 55435-1810
Phone (607) 400-6374

Other names 1

  • Callie Stark Former name

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
I20240125000831 MN Practitioner - Mental Health Counselor 0749633873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Mental Health Systems, PCGroup PAC ID 5496710790, 18 clinicians

Practice addresses (Care Compare)

6600 France S Ave
Suite 230
Edina, MN 55435-1810
Phone (952) 835-2002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4133MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Systems PC CurrentSince Jan 10, 2024 Accepting new patients
Advanced Behavior Consultants Behavior Technician Past Accepting new patients

Locations

6600 France Ave S
Ste 230
Minneapolis, MN 55435
Phone (952) 460-9007

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1083180889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S STE 230",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351810",
            "telephone_number": "607-400-6374",
            "fax_number": "607-317-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351805",
            "telephone_number": "952-835-2002",
            "fax_number": "952-835-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZNICK",
        "first_name": "CALLIE",
        "credential": "LMHC, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "4133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CALLIE",
            "last_name": "STARK",
            "credential": "RBT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.