CORI CHRISTINA BOEHM-PETERSON (LICSW) – Mental Health Counselor, NPI 1376856518

CORI CHRISTINA BOEHM-PETERSON (LICSW) is a healthcare provider. based in Minneapolis, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 14296 (MN). The NPI Number for CORI CHRISTINA BOEHM-PETERSON (LICSW) is 1376856518

Main info

Female
22 Years Of Experience
Name
CORI CHRISTINA BOEHM-PETERSON (LICSW)
NPI
1376856518
Phone
(612) 873-3000
Address
701 PARK AVE
Enumeration Date
16 July 2010
Last Update Date
25 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6122685858
Graduation Year
2004 (22 years ago)
PAC ID
4981937760
Group Practice PAC ID
0749528552
Professional Enrollment ID
I20190611000016
Address ID
MN554232712RI6636XSXXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:15State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for CORI CHRISTINA BOEHM-PETERSON (LICSW)

  • 701 PARK AVE

    MINNEAPOLIS, MN 554151623

    Phone: (612) 873-3000

    Type: Mailing

  • 6636 CEDAR AVE S STE 360

    RICHFIELD, MN 554232712

    Phone: (612) 998-8934

    Type: Location

  • 7401 Metro Blvd Ste 250

    Edina, MN 554393062

    Phone: (612) 998-8934

    Type: Location

  • 701 Park Ave

    Minneapolis, MN 554151623

    Phone: (612) 873-4304

    Fax: (612) 904-4304

    Type: Location

  • 2055 TEMPLE CT

    SAINT PAUL, MN 551045089

    Phone: (651) 603-8504

    Type: Mailing

  • 12601 RIDGEDALE DR

    MC- W741

    MINNETONKA, MN 553051911

    Phone: (612) 998-2009

    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: 2019-06-11

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
I20190611000016IClinical Social WorkerMNTBD

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
90791Psychiatric diagnostic evaluation1212$0
View full utilization report →

Insurance plans in this area (ZIP 55415)

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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: 0749528552View full group profile
NameSpecialtyState
Mental Health CounselorMN
Mental Health CounselorMN
Clinical PsychologistMN
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Marriage And Family TherapistMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Marriage And Family TherapistMN

Reviews

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Frequently asked questions

How is CORI CHRISTINA BOEHM-PETERSON (LICSW) identified in CMS data?
CMS-hosted NPPES data lists CORI CHRISTINA BOEHM-PETERSON (LICSW) with NPI 1376856518.
Can I rely on CORI CHRISTINA BOEHM-PETERSON (LICSW) being an active provider?
As of the registry snapshot, CORI CHRISTINA BOEHM-PETERSON (LICSW) is marked active.
What is CORI CHRISTINA BOEHM-PETERSON (LICSW)'s specialty?
The listing groups CORI CHRISTINA BOEHM-PETERSON (LICSW) with Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Where is CORI CHRISTINA BOEHM-PETERSON (LICSW) based?
CORI CHRISTINA BOEHM-PETERSON (LICSW) is tied to Minneapolis, Minnesota in the data we show; additional addresses may exist on the full record.
Is the information about CORI CHRISTINA BOEHM-PETERSON (LICSW) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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