Carissa Tchalla

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4511 Issued in MN

Practice address

3033 Excelsior Blvd Ste 365
Minneapolis, MN 55416-4688

Phone

(612) 979-2276

NPI assigned

Aug 14, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

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.

• Thrive Therapy and Wellness LLC

  • Marriage & Family Therapist
  • Oakdale, MN
  • NPI 1073303483
  Medicare reassignment NPD Authorized official
• Lyn-Lake Psychotherapy and Wellness LTD.

  • Clinical Psychologist
  • Minneapolis, MN
  • NPI 1609355163
  Medicare reassignment NPD

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1821871971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 BALLANTRAE RD APT 10",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221511",
            "telephone_number": "763-443-9537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 EXCELSIOR BLVD STE 365",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164688",
            "telephone_number": "612-979-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TCHALLA",
        "first_name": "CARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tayo Home Health Care Inc
• Tayo Transportation Inc
• Melissa Esperanza Tayun-Perez
• Hamed Tayyebi
• TC Care Transportation Inc
• Stefan Tchepichev, MD
• Viviane Tchonang Leuche, M.D.
• Ulrich Lengrand Tchouta
• Alicia M Teagarden, D.O.
• Rebekah Ann Teague, P.A.

• Marriage & Family Therapist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.