MARK ERIC ANDERSON (MA LP LMFT) – Clinical Psychologist, NPI 1649372590

MARK ERIC ANDERSON (MA LP LMFT) is a healthcare provider. based in New brighton, Minnesota. specializing in MARRIAGE AND FAMILY THERAPIST. They hold the professional credentials MA LP LMFT. They hold a License No. 1064 (MN). The NPI Number for MARK ERIC ANDERSON (MA LP LMFT) is 1649372590

Main info

Male
35 Years Of Experience
Name
MARK ERIC ANDERSON (MA LP LMFT)
NPI
1649372590
Phone
(651) 482-9361
Address
900 LONG LAKE RD
Enumeration Date
2 September 2006
Last Update Date
1 April 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6514829361
Graduation Year
1991 (35 years ago)
PAC ID
5991157950
Group Practice PAC ID
3173429214
Professional Enrollment ID
I20240116002323
Address ID
MN551126439NE900XXRDXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:19State licenses:2Digital endpointsOther names

981 MARRIAGE AND FAMILY THERAPIST in MN

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Provider Addresses for MARK ERIC ANDERSON (MA LP LMFT)

  • Long Lake Rd, County Road D West, New Brighton, Ramsey County, Minnesota, 55112, United States

    SUITE 320 ARDEN WOODS PSYCHOLOGICAL SERVICES

    NEW BRIGHTON, MN 551126428

    Phone: (651) 482-9361

    Fax: (651) 482-9888

    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: 2024-01-16

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
I20240116002323IMarriage 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 55112)

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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: 3173429214View full group profile
NameSpecialtyState
-MN
Marriage And Family TherapistMN
Marriage And Family TherapistMN
Clinical PsychologistMN
Mental Health CounselorMN
-MN
Marriage And Family TherapistMN
Clinical PsychologistMN
Clinical PsychologistMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

Is MARK ERIC ANDERSON (MA LP LMFT) listed with a National Provider Identifier?
Yes — MARK ERIC ANDERSON (MA LP LMFT) has NPI 1649372590 on file in the registry.
Active or inactive — what applies to MARK ERIC ANDERSON (MA LP LMFT)?
You should see MARK ERIC ANDERSON (MA LP LMFT) as active in CMS-hosted NPPES data.
What expertise is attributed to MARK ERIC ANDERSON (MA LP LMFT)?
MARK ERIC ANDERSON (MA LP LMFT)'s specialty line reads Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Is MARK ERIC ANDERSON (MA LP LMFT) located near New Brighton?
MARK ERIC ANDERSON (MA LP LMFT) currently maps to New Brighton, Minnesota in this extract.
Can I trust this NPI listing for MARK ERIC ANDERSON (MA LP LMFT)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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