MORGAN BOBO – Clinical Psychologist, NPI 1629600010

MORGAN BOBO is a healthcare provider. based in Prior lake, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold a License No. LP6774 (MN). The NPI Number for MORGAN BOBO is 1629600010

Main info

Female
6 Years Of Experience
Name
MORGAN BOBO
NPI
1629600010
Phone
Not provided
Address
16180 HASTINGS AVE SE
Enumeration Date
4 February 2020
Last Update Date
13 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7635310566106
Graduation Year
2020 (6 years ago)
PAC ID
4183169550
Group Practice PAC ID
3870545668
Professional Enrollment ID
I20240710000158
Address ID
MN553163595CH11165NXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

Provider Addresses for MORGAN BOBO

  • 16180 HASTINGS AVE SE

    PRIOR LAKE, MN 553729227

    Phone:

    Type: Mailing

  • 11165 ZEALAND AVE N

    CHAMPLIN, MN 553163595

    Phone: (763) 531-0566

    Fax: (763) 531-0602

    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: 2024-07-10

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
I20240710000158IClinical 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 55372)

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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: 3870545668View full group profile
NameSpecialtyState
Clinical PsychologistMN
Marriage And Family TherapistMN
Clinical PsychologistMN
-MN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

What NPI should I save for MORGAN BOBO?
Save NPI 1629600010 if you need a stable reference for MORGAN BOBO.
Does this profile mean MORGAN BOBO is currently active?
Yes — MORGAN BOBO appears active in the national provider directory.
Can you summarize MORGAN BOBO's specialty in plain language?
Clinically, the directory lists MORGAN BOBO with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Does MORGAN BOBO practice in Minnesota?
You will see Prior Lake, Minnesota on file for MORGAN BOBO alongside any extra practice locations.
Is MORGAN BOBO a real provider?
This page reflects official NPPES data for NPI 1629600010. Always confirm identity and privileges with the practice and licensing boards.

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