Individual provider Active NPI

Brianna Marie Pezon, MSW, LICSW, MAOL

  • Mental Health Counselor
  • Edina, MN
National Provider Identifier
1366909285
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
7401 Metro Blvd Ste 250
Edina, MN 55439-3062
Phone
(612) 807-9324
NPI assigned
Feb 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

7401 Metro Blvd Ste 250
Edina, MN 55439-3062

Mailing address

7401 Metro Blvd Ste 250
Edina, MN 55439-3062
Phone (612) 268-5858

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
I20221005000906 MN Practitioner - Clinical Social Worker 0547646119 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psych Recovery IncGroup PAC ID 3779633912, 22 clinicians

Practice addresses (Care Compare)

2550 University Ave W
Suite 229 N
St. Paul, MN 55114-1052

2550 University Ave W
Suite 229N
Saint Paul, MN 55114-1902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Psychological Services, P.C. Mental Health CurrentSince Oct 1, 2022 Accepting new patients
Psych Recovery Inc Clinical CurrentSince Dec 5, 2025 Accepting new patients
Associated Clinic of Psychology Inc PastSince Jul 1, 2001 Accepting new patients
Psychiatric Recovery PA Past Accepting new patients

Locations

7401 Metro Blvd
Ste 250
Minneapolis, MN 55439
Phone (612) 778-8393

7401 Metro Blvd
Ste 525
Minneapolis, MN 55439

3400 1st St N
Ste 101
Saint Cloud, MN 56303
Phone (320) 202-2000

2550 University Ave W
Ste 229N
Saint Paul, MN 55114
Phone (651) 645-3115

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1366909285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 METRO BLVD STE 250",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554393062",
            "telephone_number": "612-268-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 METRO BLVD STE 250",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554393062",
            "telephone_number": "612-807-9324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZON",
        "first_name": "BRIANNA",
        "middle_name": "MARIE",
        "credential": "MSW, LICSW, MAOL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.