ANDREW CARSON (MA) – Mental Health Counselor, NPI 1124624614

ANDREW CARSON (MA) is a healthcare provider. based in Plymouth, Minnesota. specializing in MARRIAGE AND FAMILY THERAPIST. They hold the professional credentials MA. They hold a License No. 4464 (MN). The NPI Number for ANDREW CARSON (MA) is 1124624614

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
ANDREW CARSON (MA)
NPI
1124624614
Phone
(612) 223-8898
Address
4100 BERKSHIRE LN N STE 250
Enumeration Date
9 December 2020
Last Update Date
13 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6122238898
Graduation Year
2017 (9 years ago)
PAC ID
7214475458
Group Practice PAC ID
7517181266
Professional Enrollment ID
I20240819002581
Address ID
MN554463813PL4100XNXXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

981 MARRIAGE AND FAMILY THERAPIST in MN

Provider Addresses for ANDREW CARSON (MA)

  • 4100 BERKSHIRE LN N STE 250

    PLYMOUTH, MN 554463813

    Phone: (612) 223-8898

    Fax: (833) 972-0904

    Type: Location

  • 1601 4TH AVE S

    BUFFALO, MN 553131283

    Phone: (763) 245-2576

    Type: Mailing

  • 3021 HARBOR LN N STE 206

    PLYMOUTH, MN 554475120

    Phone: (763) 559-1640

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240819002581IMarriage And Family TherapistMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55446)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7517181266View full group profile
NameSpecialtyState
Clinical PsychologistMN
Clinical PsychologistMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Mental Health CounselorMN
-MN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

Can I use this page to confirm ANDREW CARSON (MA)'s NPI?
Yes. ANDREW CARSON (MA) is listed with NPI 1124624614 in the public NPI dataset.
Can I rely on ANDREW CARSON (MA) being an active provider?
As of the registry snapshot, ANDREW CARSON (MA) is marked active.
What is ANDREW CARSON (MA)'s primary classification?
Mental Health Counselor is the headline specialty for ANDREW CARSON (MA) here. Clinical services aligned with this taxonomy classification.
Where should I expect ANDREW CARSON (MA) on a map?
Expect Plymouth, Minnesota as a primary anchor for ANDREW CARSON (MA) unless the record lists multiple sites.
Is the information about ANDREW CARSON (MA) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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