Individual provider Active NPI

Carla Cowan

  • Clinical Psychologist
  • Saint Paul, MN
National Provider Identifier
1598830705
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3644 Issued in MN
Practice address
451 Lexington Pkwy N
Saint Paul, MN 55104-4636
Phone
(651) 280-2310
NPI assigned
Nov 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3644 MN Primary

Addresses

Primary practice location

451 Lexington Pkwy N
Saint Paul, MN 55104-4636

Mailing address

1275 Belmont LN W
Roseville, MN 55113-5901

Other identifiers 2

IdentifierTypeStateIssuer
716118200OtherMNMEDICAL ASSISTANCE
1598830705OtherMNNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1 Optum Cir
Eden Prairie, MN 55344-2956

451 Lexington Pkwy N
Saint Paul, MN 55104-4636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Colorado, P.C. Clinical Current Accepting new patients

Locations

7601 Wayzata Blvd
St Louis Park, MN 55426
Phone (612) 223-8899

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1598830705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 BELMONT LN W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551135901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 LEXINGTON PKWY N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044636",
            "telephone_number": "651-280-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWAN",
        "first_name": "CARLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "3644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "716118200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1598830705",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.