Individual provider Active NPI

Suzanne M Lee, DNP

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Coon Rapids, MN
National Provider Identifier
1275709222
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
R 062497-8 Issued in MN
Practice address
3361 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2624
Phone
(763) 427-1950
Fax
(763) 427-7006
NPI assigned
Apr 30, 2008
Last updated
Mar 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X R 062497-8 MN Primary

Addresses

Primary practice location

3361 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2624

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1275709222MedicaidMN

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090713000533 MN Practitioner - Certified Clinical Nurse Specialist (CNS) 7214089846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13501 Balsam LN N
Suite 110
Dayton, MN 55327-9469

646 E River Rd
Suite 1
Anoka, MN 55303-1891
Phone (763) 427-1950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R 062497-8MNMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Cor Counseling Services LLC CurrentSince Jan 1, 2014 Accepting new patients
Beacon Therapy Associates, PC PastSince Feb 1, 2018 Accepting new patients

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

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": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1275709222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3361 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332624",
            "telephone_number": "763-427-1950",
            "fax_number": "764-427-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3361 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332624",
            "telephone_number": "763-427-1950",
            "fax_number": "763-427-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUZANNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-30",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MN",
            "license": "R 062497-8",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275709222",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.