Organization Active NPI

Memor Mental Health, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Louis Park, MN
National Provider Identifier
1265229199
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MEMOR MENTAL HEALTH, PLLC
Practice address
3340 Republic Ave Ste 120
St Louis Park, MN 55426-4189
Phone
(574) 360-9621
NPI assigned
Apr 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Authorized official

Name
Carrie Sweetser, PSY.DNPI 1659685774
Title
Clinical Psychologist, Owner
Phone
(574) 360-9621

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3340 Republic Ave Ste 120
St Louis Park, MN 55426-4189

Mailing address

3340 Republic Ave Ste 120
St Louis Park, MN 55426-4189

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250811002505 MN Part B Supplier - Clinic/Group Practice 8921506783 Receives reassigned benefits from 1 practitioner
Practice locations: St Louis Park, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1265229199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 REPUBLIC AVE STE 120",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 REPUBLIC AVE STE 120",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264189",
            "telephone_number": "574-360-9621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMOR MENTAL HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "SWEETSER",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST, OWNER",
        "authorized_official_telephone_number": "574-360-9621",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; 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.