Organization Active NPI

Cor Counseling Services LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Anoka, MN
National Provider Identifier
1144575994
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavioral Neurology & Neuropsychiatry PhysicianTaxonomy code 2084B0040X
License
362576 Issued in MN
Legal business name
COR COUNSELING SERVICES LLC
Practice address
646 E River Rd Ste 1
Anoka, MN 55303
Phone
(637) 427-1950
Fax
(763) 427-7006
NPI assigned
Jul 18, 2012
Last updated
Nov 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Authorized official

Name
Dr. Suzanne Lee, DNPNPI 1275709222
Title
Partner
Phone
(763) 427-1950

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavioral Neurology & Neuropsychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084B0040X 362576 MN Primary

Addresses

Primary practice location

646 E River Rd Ste 1
Anoka, MN 55303

Mailing address

646 E River Rd Ste 1
Anoka, MN 55303-1891
Phone (637) 427-1950

Other practice location 1

3361 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2624
Phone (763) 427-1950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140204000803 MN Part B Supplier - Clinic/Group Practice 3870722317 Receives reassigned benefits from 1 practitioner
Practice locations: Anoka, MN

National Provider Directory

National Provider Directory

Locations

646 E River Rd
Ste 1
Anoka, MN 55303
Phone (763) 427-1950

3361 Coon Rapids Blvd NW
Coon Rapids, MN 55433
Phone (612) 644-6373

13501 Balsam Ln N
Ste 110
Dayton, MN 55327

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542758400000",
    "number": "1144575994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 E RIVER RD STE 1",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553031891",
            "telephone_number": "637-427-1950",
            "fax_number": "763-427-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 E RIVER RD STE 1",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "55303",
            "telephone_number": "637-427-1950",
            "fax_number": "763-427-7006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3361 Coon Rapids Blvd NW",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554332624",
            "country_code": "US",
            "telephone_number": "763-427-1950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COR COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2018-11-21",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "763-427-1950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "MN",
            "license": "362576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anoka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.