CARISSA BRANDT – Clinical Psychologist, NPI 1174078455

CARISSA BRANDT is a healthcare provider. based in Woodbury, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold a License No. 6265 (MN). The NPI Number for CARISSA BRANDT is 1174078455

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
CARISSA BRANDT
NPI
1174078455
Phone
(763) 522-1450
Address
1811 WEIR DR STE 270
Enumeration Date
16 August 2016
Last Update Date
7 May 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6517600866
Graduation Year
2009 (17 years ago)
PAC ID
8224388483
Group Practice PAC ID
0042642449
Professional Enrollment ID
I20180910000671
Address ID
MN551152060MA760XXRDXX301
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:9State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

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Provider Addresses for CARISSA BRANDT

  • Weir Drive, Woodbury, Washington County, Minnesota, 55125, United States

    WOODBURY, MN 551256741

    Phone: (763) 522-1450

    Mailing address matches the actual address.

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: 2018-09-10

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
I20180910000671IClinical 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.

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

Insurance plans in this area (ZIP 55125)

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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: 0042642449View full group profile
NameSpecialtyState
Clinical PsychologistMN
Clinical PsychologistMN
Clinical PsychologistCO

Reviews

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Frequently asked questions

What federal number belongs to CARISSA BRANDT?
The federal identifier for CARISSA BRANDT is NPI 1174078455.
Is CARISSA BRANDT currently active in the NPI registry?
CMS-published data lists CARISSA BRANDT as an active registrant.
Can you summarize CARISSA BRANDT's specialty in plain language?
Clinically, the directory lists CARISSA BRANDT with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where does public data place CARISSA BRANDT?
The snapshot lists Woodbury, Minnesota for CARISSA BRANDT; download NPPES for the complete set.
What if Woodbury, Minnesota seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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