Individual provider Active NPI

Raeannan Linnae Roos, LPCC

  • Professional Counselor
  • Edina, MN
National Provider Identifier
1992528426
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4659 Issued in MN
Practice address
6600 France Ave S Ste 230
Edina, MN 55435-1810
Phone
(952) 460-9025
NPI assigned
Nov 4, 2024
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4659 MN Primary

Addresses

Primary practice location

6600 France Ave S Ste 230
Edina, MN 55435-1810

Mailing address

6600 France Ave S Ste 230
Edina, MN 55435-1810
Phone (952) 460-9025

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
I20250220000789 MN Practitioner - Mental Health Counselor 5395265441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Mental Health Systems, PCGroup PAC ID 5496710790, 18 clinicians

Practice addresses (Care Compare)

6600 France S Ave
Suite 230
Edina, MN 55435-1810
Phone (952) 835-2002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4659MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Systems PC CurrentSince Dec 15, 2024 Accepting new patients

Locations

6600 France Ave S
Ste 230
Minneapolis, MN 55435
Phone (952) 460-9007

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": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1992528426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S STE 230",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351810",
            "telephone_number": "952-460-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S STE 230",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351810",
            "telephone_number": "952-460-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOS",
        "first_name": "RAEANNAN",
        "middle_name": "LINNAE",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "4659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.