Individual provider Active NPI

Desiree Yvette Phillips, LPCC

  • Mental Health Counselor
  • Rosemount, MN
National Provider Identifier
1932846946
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC03290 Issued in MN
Practice address
15265 Carrousel Way
Rosemount, MN 55068-1760
Phone
(952) 443-4600
Fax
(952) 443-4604
NPI assigned
May 19, 2022
Last updated
May 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CC03290 MN Primary

Addresses

Primary practice location

15265 Carrousel Way
Rosemount, MN 55068-1760

Mailing address

15265 Carrousel Way
Rosemount, MN 55068-1760
Phone (952) 443-4600

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
I20240108000666 MN Practitioner - Mental Health Counselor 6002267721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lorenz Clinic LLCGroup PAC ID 7810282845, 24 clinicians

Practice addresses (Care Compare)

15265 Carrousel Way
Suite 100
Rosemount, MN 55068-1760
Phone (952) 443-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC03290MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lorenz Clinic, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

15265 Carrousel Way
Ste 100
Rosemount, MN 55068
Phone (951) 443-4600

1772 Stieger Lake Ln
Ste 220
Victoria, MN 55386
Phone (952) 433-4600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16506/brand/1/csg/1/fhir/r4

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, 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": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1932846946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15265 CARROUSEL WAY",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550681760",
            "telephone_number": "952-443-4600",
            "fax_number": "952-443-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15265 CARROUSEL WAY",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550681760",
            "telephone_number": "952-443-4600",
            "fax_number": "952-443-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "DESIREE",
        "middle_name": "YVETTE",
        "name_prefix": "Mrs.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC03290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosemount, MN

Sources for this page

Verify at the official NPI Registry.