Individual provider Active NPI

Andrew Philip Braum, MA LPCC

  • Mental Health Counselor
  • White Bear Lake, MN
National Provider Identifier
1447700984
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC00988 Issued in MN
Practice address
1895 County Road E E Ste 213
White Bear Lake, MN 55110-4614
Phone
(651) 210-6133
NPI assigned
Oct 8, 2016
Last updated
Oct 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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 CC00988 MN Primary

Addresses

Primary practice location

1895 County Road E E Ste 213
White Bear Lake, MN 55110-4614

Mailing address

4010 Crestwood PL
White Bear Lake, MN 55110-4238
Phone (651) 210-6133

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
I20240828001052 MN Practitioner - Mental Health Counselor 8022557560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Lyn-Lake Psychotherapy and Wellness LTDGroup PAC ID 9638581291, 72 clinicians

Practice addresses (Care Compare)

621 W Lake St
Suite 350
Minneapolis, MN 55408-2952
Phone (612) 979-2276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC00988MNMDMental Health Counselor
988MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lyn-Lake Psychotherapy and Wellness LTD. Mental Health CurrentSince Jun 16, 2024 Accepting new patients

Locations

2900 Thomas Ave S
Ste 100
Minneapolis, MN 55416

621 W Lake St
Ste 350
Minneapolis, MN 55408
Phone (612) 547-9990

Organizations & group practices 1

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": "1475884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1447700984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 CRESTWOOD PL",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551104238",
            "telephone_number": "651-210-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 COUNTY ROAD E E STE 213",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551104614",
            "telephone_number": "651-210-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUM",
        "first_name": "ANDREW",
        "middle_name": "PHILIP",
        "credential": "MA  LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-08",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC00988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

Verify at the official NPI Registry.