Active NPI
Saari Anne McCornack, PSYD
- Clinical Psychologist
- Big Lake, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5789
- Practice address
- 207 Jefferson Blvd
Big Lake, MN 55309-4667 - Phone
- (763) 263-7897
- NPI assigned
- Nov 28, 2018
- Last updated
- Nov 28, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5789 | MN | Primary |
Addresses
Primary practice location
207 Jefferson Blvd
Big Lake, MN 55309-4667
Mailing address
1900 Silver Lake Rd NW
New Brighton, MN 55112-1786
Phone (651) 379-1718
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5789 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Karol, PC | Clinical | Current | Accepting new patients |
| Fairview Express Care | Current | Accepting new patients | |
| Hennepin County | Current | Accepting new patients | |
| Brain Health Group LLC | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Hennepin County | Clinical | Current | Accepting new patients |
| Fairview Express Care | Current | Accepting new patients | |
| Hennepin County | Current | Accepting new patients | |
| Nystrom & Associates, LTD | Past | Accepting new patients | |
| Family Support Services Inc. | Past | Accepting new patients |
Locations
11800 Singletree Ln
Ste 203
Eden Prairie, MN 55344
Phone (651) 503-9404
1801 Nicollet Ave
Minneapolis, MN 55403
Phone (612) 596-0900
2215 E Lake St
Minneapolis, MN 55407
Phone (612) 596-0900
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
2700 Snelling Ave N
Ste 400
Saint Paul, MN 55113
Phone (651) 697-5804
Organizations & group practices 10
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.
-
- Clinical Neuropsychologist
- Eden Prairie, MN
- NPI 1477144384
-
dba M Health Fairview Recovery Clinic
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
dba Hennepin County Mental Health Center
- Psychiatry Physician
- Minneapolis, MN
- NPI 1780790345
Clinical
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
-
dba NorthPoint Health & Wellness Center - Workforce Center Medical
- Community Health Clinic/Center
- Minneapolis, MN
- NPI 1154774925
-
dba Endeavors
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1962147413
-
dba Karol Neuropsychological Services & Consulting
- Clinical Neuropsychologist
- Eden Prairie, MN
- NPI 1053383679
-
dba Sagent Behavioral Health
- Mental Health Counselor
- New Brighton, MN
- NPI 1467549220
-
dba Sagent Behavioral Health
- Clinical Social Worker
- New Brighton, MN
- NPI 1396750188
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543363200000",
"number": "1518437912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 SILVER LAKE RD NW",
"city": "NEW BRIGHTON",
"state": "MN",
"postal_code": "551121786",
"telephone_number": "651-379-1718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 JEFFERSON BLVD",
"city": "BIG LAKE",
"state": "MN",
"postal_code": "553094667",
"telephone_number": "763-263-7897"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORNACK",
"first_name": "SAARI",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-28",
"last_updated": "2018-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "5789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Big Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.