Individual provider Active NPI

Courtney Caryl Breyer, MA, LADC, LPCC

  • Mental Health Counselor
  • Plymouth, MN
National Provider Identifier
1851917728
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2521 Issued in MN
Practice address
12805 Hwy 55 Ste 212
Plymouth, MN 55441-3880
Phone
(612) 234-1505
Fax
(612) 230-4120
NPI assigned
Jun 17, 2020
Last updated
Aug 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 305032 MN
Mental Health Counselor 101YM0800X 2521 MN Primary

Addresses

Primary practice location

12805 Hwy 55 Ste 212
Plymouth, MN 55441-3880

Mailing address

12805 Hwy 55 Ste 212
Plymouth, MN 55441-3880
Phone (612) 234-1505

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240628000718 MN Practitioner - Mental Health Counselor 9133571177 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12805 Hwy 55
Suite 212
Plymouth, MN 55441-3880
Phone (612) 234-1505

2854 Hwy 55
Suite 130
Eagan, MN 55121-1447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
305032MNMDAddiction (Substance Use Disorder) Counselor
2521MNMDNeonatal/Pediatric Registered Respiratory Therapist
02521MNMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Recovery Inc CurrentSince Apr 2, 2024 Accepting new patients
Whats on the Brain Therapy Services LLC Mental Health CurrentSince Sep 19, 2024 Accepting new patients
Canvas Health, Inc. Mental Health CurrentSince Sep 17, 2023 Accepting new patients
Psychiatric Recovery PA Past Accepting new patients

Locations

1701 E 79th St
Ste 4
Bloomington, MN 55425
Phone (612) 676-1604

12805 Highway 55
Ste 212
Plymouth, MN 55441
Phone (612) 234-1505

2550 University Ave W
Ste 229N
Saint Paul, MN 55114
Phone (651) 645-3115

2854 Highway 55
Ste 130
Saint Paul, MN 55121
Phone (651) 224-4930

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1851917728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12805 HWY 55 STE 212",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554413880",
            "telephone_number": "612-234-1505",
            "fax_number": "612-230-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12805 HWY 55 STE 212",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554413880",
            "telephone_number": "612-234-1505",
            "fax_number": "612-230-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREYER",
        "first_name": "COURTNEY",
        "middle_name": "CARYL",
        "credential": "MA, LADC, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305032",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "2521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.