Lauren Callis, LPCC, ATR

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC03173 Issued in MN

Practice address

6550 York Ave S
Edina, MN 55435-2347

Phone

(952) 426-3034

NPI assigned

Oct 20, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mary Mullenbach, PHD, LP, Inc

  • Psychologist
  • Edina, MN
  • NPI 1801182837
  Medicare reassignment NPD
• Minnesota Allergy & Asthma LLC

  • Allergy & Immunology Physician
  • Edina, MN
  • NPI 1881736544
  NPD (past)

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1740062066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 E LAKE ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062148",
            "telephone_number": "605-595-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 YORK AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352347",
            "telephone_number": "952-426-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLIS",
        "first_name": "LAUREN",
        "credential": "LPCC, ATR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-20",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "MN",
            "license": "CC03173",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC03173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Call, MD
• William A Callahan
• Jason Callanan, MSW
• Edward Charles Callaway, M.D.
• Magan Anne Callaway, LICSW
• Jose Miguel Calvo, C.R.N.A
• Stephanie Nicole Cameron
• Emily Lauren Camp, PT, DPT
• Nicole Campbell, MSW, LICSW
• Ralph Blane Campbell III, LADC

• Mental Health Counselor in Edina, MN
• Providers in Edina, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.

Verify at the official NPI Registry.