Active NPI
Andrew Carson, MA
- Mental Health Counselor
- Plymouth, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 4100 Berkshire LN N Ste 250
Plymouth, MN 55446-3813 - Phone
- (612) 223-8898
- Fax
- (833) 972-0904
- NPI assigned
- Dec 9, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4464 | MN | |
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
4100 Berkshire LN N Ste 250
Plymouth, MN 55446-3813
Mailing address
1601 4TH Ave S
Buffalo, MN 55313-1283
Phone (763) 245-2576
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4100 Berkshire LN N
Suite 250
Plymouth, MN 55446-3813
Phone (612) 223-8898
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4464 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Behavioral Care of Colorado, P.C. | Current | Accepting new patients | |
| Plymouth Psych Group, LLC | Mental Health | Current | Accepting new patients |
| Optum Behavioral Care of Colorado, P.C. | Current | Accepting new patients | |
| Care Clinics, LLC | Current | Accepting new patients | |
| Optum Behavioral Care of Colorado, P.C. | Current | Accepting new patients | |
| Optum Behavioral Care of Colorado PC | Past | Accepting new patients |
Locations
7400 W 109th St
Bloomington, MN 55438
Phone (952) 886-3268
4100 Berkshire Ln N
#250
Plymouth, MN 55446
3021 Harbor Ln N
Ste 206
Plymouth, MN 55447
Phone (763) 559-1640
4100 Berkshire Ln N
Ste 250
Plymouth, MN 55446
9655 Schmidt Lake Rd
Ste 150
Plymouth, MN 55442
Phone (763) 559-1640
7601 Wayzata Blvd
St Louis Park, MN 55426
Phone (612) 223-8899
Organizations & group practices 6
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.
-
- Clinical Psychologist
- Baxter, MN
- NPI 1124898556
-
- Mental Health Counselor
- Plymouth, MN
- NPI 1003195942
-
- Psychologist
- St Louis Park, MN
- NPI 1851716245
-
- Clinical Psychologist
- Minneapolis, MN
- NPI 1053181487
-
- Clinical Social Worker
- De Pere, WI
- NPI 1396622494
-
- Psychologist
- Edina, MN
- NPI 1336967561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731456000000",
"number": "1124624614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 4TH AVE S",
"city": "BUFFALO",
"state": "MN",
"postal_code": "553131283",
"telephone_number": "763-245-2576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 BERKSHIRE LN N STE 250",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554463813",
"telephone_number": "612-223-8898",
"fax_number": "833-972-0904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARSON",
"first_name": "ANDREW",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-09",
"last_updated": "2024-11-13",
"certification_date": "2024-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "4464",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.