DEANNA PELLEY (MA LPCC) – Mental Health Counselor, NPI 1912576166

DEANNA PELLEY (MA LPCC) is a healthcare provider. based in Fridley, Minnesota. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA LPCC. They hold a License No. CC02864 (MN). The NPI Number for DEANNA PELLEY (MA LPCC) is 1912576166

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
DEANNA PELLEY (MA LPCC)
NPI
1912576166
Phone
(763) 572-2612
Address
7260 UNIVERSITY AVE NE STE 235
Enumeration Date
22 June 2021
Last Update Date
22 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6128254792
Graduation Year
2016 (10 years ago)
PAC ID
2961937388
Group Practice PAC ID
4284169723
Professional Enrollment ID
I20241122000067
Address ID
MN554164758MI4208XRDXX400

Contacts

Main Contact
computer
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness85
Years active:4State licenses:1Other namesUpdated within 12 months

1,813 MENTAL HEALTH COUNSELOR in MN

Provider Addresses for DEANNA PELLEY (MA LPCC)

  • 7260 UNIVERSITY AVE NE STE 235

    FRIDLEY, MN 554323141

    Phone: (763) 572-2612

    Fax: (763) 572-2606

    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: 2024-11-22

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
I20241122000067IMental Health CounselorMNTBD

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 55432)

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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: 4284169723View full group profile
NameSpecialtyState
Clinical Social WorkerMN
Clinical Social WorkerMN
Mental Health CounselorMN
Clinical PsychologistMN
Clinical Social WorkerMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

What is the 10-digit NPI for DEANNA PELLEY (MA LPCC)?
DEANNA PELLEY (MA LPCC) — NPI 1912576166 — is the standard way to identify this listing.
Is DEANNA PELLEY (MA LPCC) listed as active for patients and plans?
The listing shows DEANNA PELLEY (MA LPCC) as active in the NPI system.
What is DEANNA PELLEY (MA LPCC)'s specialty?
The listing groups DEANNA PELLEY (MA LPCC) with Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What area does DEANNA PELLEY (MA LPCC) serve?
DEANNA PELLEY (MA LPCC)'s listing highlights Fridley, Minnesota; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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