DR. WILLIE BERNARD GARRETT (MS-LP, ED.D.) – Psychologist, NPI 1780691592

DR. WILLIE BERNARD GARRETT (MS-LP, ED.D.) is a healthcare provider. based in Saint paul, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials MS-LP, ED.D.. They hold a License No. LP1234 (MN). The NPI Number for DR. WILLIE BERNARD GARRETT (MS-LP, ED.D.) is 1780691592

Main info

Male
Sole Proprietor
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. WILLIE BERNARD GARRETT (MS-LP, ED.D.)
NPI
1780691592
Phone
(651) 645-0980
Address
1600 UNIVERSITY AVE W STE 505
Enumeration Date
2 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7634793555
Graduation Year
2002 (24 years ago)
PAC ID
1052754249
Group Practice PAC ID
1557516184
Professional Enrollment ID
I20240205001879
Address ID
MN553572120LO3675XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

Provider Addresses for DR. WILLIE BERNARD GARRETT (MS-LP, ED.D.)

  • 1600 UNIVERSITY AVE W STE 505

    SAINT PAUL, MN 551043825

    Phone: (651) 645-0980

    Fax: (651) 645-3534

    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: 2024-02-05

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
I20240205001879IClinical 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 55104)

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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: 1557516184View full group profile
NameSpecialtyState
P S Y C H I A T R YMN
Nurse PractitionerMN
Nurse PractitionerIA
Mental Health CounselorMN
Clinical PsychologistMN
Mental Health CounselorMN
-MN
Mental Health CounselorMN

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Frequently asked questions

Is there an official ID for DR. WILLIE BERNARD GARRETT (MS-LP, ED.D.) in U.S. healthcare records?
The official identifier for DR. WILLIE BERNARD GARRETT (MS-LP, ED.D.) is NPI 1780691592.
Is there an active status for DR. WILLIE BERNARD GARRETT (MS-LP, ED.D.)?
For scheduling context, DR. WILLIE BERNARD GARRETT (MS-LP, ED.D.) is shown as active in the registry.
What kind of doctor is DR. WILLIE BERNARD GARRETT (MS-LP, ED.D.)?
DR. WILLIE BERNARD GARRETT (MS-LP, ED.D.) is associated with Psychologist in the directory — Clinical services aligned with this taxonomy classification.
Where in Minnesota is DR. WILLIE BERNARD GARRETT (MS-LP, ED.D.) registered?
Use Saint Paul, Minnesota as the headline location for DR. WILLIE BERNARD GARRETT (MS-LP, ED.D.) here.
When was this NPI issued?
Enumeration for DR. WILLIE BERNARD GARRETT (MS-LP, ED.D.) is noted as August 2, 2006 where the registry provides it.

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