ADRIENNE AMANDA PAULSON (PHD) – Mental Health Counselor, NPI 1154640506

ADRIENNE AMANDA PAULSON (PHD) is a healthcare provider. based in Monticello, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. The NPI Number for ADRIENNE AMANDA PAULSON (PHD) is 1154640506

Main info

Female
18 Years Of Experience
Accepts Medicare Assignment
Name
ADRIENNE AMANDA PAULSON (PHD)
NPI
1154640506
Phone
(763) 295-4001
Address
407 WASHINGTON ST
Enumeration Date
25 May 2010
Last Update Date
12 May 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3202522976
Graduation Year
2008 (18 years ago)
PAC ID
9537293824
Group Practice PAC ID
2860447604
Professional Enrollment ID
I20100823000938
Address ID
MN563871314WA110XXSTXX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:16State licenses:0Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

Provider Addresses for ADRIENNE AMANDA PAULSON (PHD)

  • 407 WASHINGTON ST

    MONTICELLO, MN 553628815

    Phone: (763) 295-4001

    Fax: (763) 295-5086

    Type: Location

  • 110 2ND ST S

    STE 301

    WAITE PARK, MN 563871314

    Phone: (320) 252-2976

    Fax: (320) 656-1570

    Type: Mailing

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: 2010-08-23

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
I20100823000938IClinical PsychologistMNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour19212$0
View full utilization report →

Insurance plans in this area (ZIP 55362)

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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: 2860447604View full group profile
NameSpecialtyState
Clinical Social WorkerMN
P S Y C H I A T R YMN
Clinical Social WorkerIA
Marriage And Family TherapistMN
Mental Health CounselorND
Marriage And Family TherapistMN
Clinical Social WorkerMN
-MN
Clinical Social WorkerMN
-MN

Reviews

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Frequently asked questions

Is ADRIENNE AMANDA PAULSON (PHD) listed with a National Provider Identifier?
Yes — ADRIENNE AMANDA PAULSON (PHD) has NPI 1154640506 on file in the registry.
Would ADRIENNE AMANDA PAULSON (PHD) appear as active to a payer?
You can treat ADRIENNE AMANDA PAULSON (PHD) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe ADRIENNE AMANDA PAULSON (PHD)'s focus?
For ADRIENNE AMANDA PAULSON (PHD), the primary taxonomy reads as Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for ADRIENNE AMANDA PAULSON (PHD)?
Travel planning: use Monticello, Minnesota as the reference point for ADRIENNE AMANDA PAULSON (PHD), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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