Active NPI
Mental Health Systems PC
- Psychologist
- Edina, MN
National Provider Identifier
1497835656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Legal business name
- MENTAL HEALTH SYSTEMS PC
- Practice address
- 7200 France Ave
Ste 327
Edina, MN 55435-4310 - Phone
- (952) 835-2002
- Fax
- (952) 835-9889
- NPI assigned
- Oct 16, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mark Richard Carlson, PSYD LP
- Title
- President
- Phone
- (952) 835-2002
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
7200 France Ave
Ste 327
Edina, MN 55435-4310
Mailing address
7200 France Ave
Ste 327
Edina, MN 55435-4310
Phone (952) 835-2002
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58068200 | Medicaid | MN | |
| 8448303 | Other | MEDICA | |
| 103953 | Other | UCARE | |
| 1034301 | Other | PREFERRED ONE | |
| 92012 | Other | HEALTH PARTNERS | |
| 124R9ME | Other | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041129000593 | MN | Part B Supplier - Clinic/Group Practice | 5496710790 |
Receives reassigned benefits from 49 practitioners Practice locations: Edina, MN; Plymouth, MN |
National Provider Directory
National Provider Directory- Tax ID family
- Mental Health Systems
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Edina, MN
- NPI 1376948810
Locations
7200 France Ave S
Ste 327
Edina, MN 55435
Phone (952) 835-2002
7200 France Ave S
Ste 135
Edina, MN 55435
Phone (952) 835-2002
11272 86th Ave N
Ste A
Maple Grove, MN 55369
Phone (763) 416-0915
3033 Campus Dr
Ste E180
Plymouth, MN 55441
Phone (952) 460-9038
6063 Hudson Rd
Ste 200
Woodbury, MN 55125
Phone (952) 460-9080
6043 Hudson Rd
Ste 290
Woodbury, MN 55125
Phone (651) 268-1363
Practitioners & affiliated clinicians
Practitioners 60
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": "1160956800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1497835656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7200 FRANCE AVE",
"address_2": "STE 327",
"city": "EDINA",
"state": "MN",
"postal_code": "554354310",
"telephone_number": "952-835-2002",
"fax_number": "952-835-9889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7200 FRANCE AVE",
"address_2": "STE 327",
"city": "EDINA",
"state": "MN",
"postal_code": "554354310",
"telephone_number": "952-835-2002",
"fax_number": "952-835-9889"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MENTAL HEALTH SYSTEMS PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-16",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "CARLSON",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "RICHARD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "952-835-2002",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PSYD LP"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "58068200",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "8448303",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "103953",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1034301",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "92012",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "124R9ME",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.