Deanna Pelley, MA LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC02864 Issued in MN

Practice address

7260 University Ave NE Ste 235
Fridley, MN 55432-3141

Phone

(763) 572-2612

Fax

(763) 572-2606

NPI assigned

Jun 22, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CGC LLCGroup PAC ID 4284169723, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• CGC LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
  • NPI 1699239566
  Medicare reassignment Care Compare group NPD
• Affiliated Counseling Center

  • Psychologist
  • Fridley, MN
  • NPI 1194836064
  NPD
• Aria Counseling Assessment and Mediation Centers PLLC

  • Psychologist
  • Fridley, MN
  • NPI 1649613837
  NPD

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1912576166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7260 UNIVERSITY AVE NE STE 235",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323141",
            "telephone_number": "763-572-2612",
            "fax_number": "763-572-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7260 UNIVERSITY AVE NE STE 235",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323141",
            "telephone_number": "763-572-2612",
            "fax_number": "763-572-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEY",
        "first_name": "DEANNA",
        "credential": "MA LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC02864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "computer",
            "affiliation": "N",
            "endpointDescription": "computer",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "computer",
            "address_1": "7260 University Ave NE Ste 235",
            "city": "Fridley",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554323141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Donald A Pavelka, M.D.
• Peaceful Adult Day Center LLC.
• Peaceful Home and Community Care LLC
• Peixin Liu DDS
• Candace K Pella, PT
• Heather Ann Penning, CNP
• Anne Perkins
• Bethany Peterson
• Dawn E Peterson, PT
• Reilly Peterson, DPT

• Mental Health Counselor in Fridley, MN
• Providers in Fridley, 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 Jun 22, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.