Innovative Psychological Consultants, Llc - Medicare Mental Health Clinic in Maple Grove, MN

Innovative Psychological Consultants, Llc is a medicare enrolled mental health clinic (Psychologist - Counseling) in Maple Grove, Minnesota. The current practice location for Innovative Psychological Consultants, Llc is 7372 Kirkwood Ct, Maple Grove, Minnesota. For appointments, you can reach them via phone at (763) 416-4167. The mailing address for Innovative Psychological Consultants, Llc is 7372 Kirkwood Ct, Maple Grove, Minnesota and phone number is (763) 416-4167.

Innovative Psychological Consultants, Llc is licensed to practice in Minnesota (license number LP4615). The clinic also participates in the medicare program and its NPI number is 1942221080. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (763) 416-4167.

Contact Information

Innovative Psychological Consultants, Llc
7372 Kirkwood Ct
Maple Grove
MN 55369-5202
(763) 416-4167
(763) 416-4137

Map and Direction


Mental Health Clinic Profile

Full NameInnovative Psychological Consultants, Llc
SpecialityPsychologist
Location7372 Kirkwood Ct, Maple Grove, Minnesota
Authorized Official Name and PositionChristian Todd Anderson (CEO)
Authorized Official Contact7634164167
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Innovative Psychological Consultants, Llc
7372 Kirkwood Ct
Maple Grove
MN 55369-5202

Ph: (763) 416-4167
Innovative Psychological Consultants, Llc
7372 Kirkwood Ct
Maple Grove
MN 55369-5202

Ph: (763) 416-4167

NPI Details:

NPI Number1942221080
Provider Enumeration Date07/22/2006
Last Update Date08/22/2020

Medicare PECOS Information:

Medicare PECOS PAC ID3678596285
Medicare Enrollment IDO20060110000633

Medical Identifiers

Medical identifiers for Innovative Psychological Consultants, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1942221080NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TA0400XPsychologist - Addiction (substance Use Disorder) LP4615 (Minnesota)Primary
103TC1900XPsychologist - Counseling LP4615 (Minnesota)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Innovative Psychological Consultants, Llc acts as a billing entity for following providers:
Provider NameThomas A Converse
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1255498556
PECOS PAC ID: 1658399753
Enrollment ID: I20051108000024
Provider NameRanji Varghese
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1255304770
PECOS PAC ID: 5890714083
Enrollment ID: I20051116000987
Provider NameChristian T Anderson
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1881618817
PECOS PAC ID: 8921021536
Enrollment ID: I20060110000672
Provider NameXan K Banker
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1427078260
PECOS PAC ID: 0446253314
Enrollment ID: I20060814000498
Provider NameJennifer G Enstad
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1093725467
PECOS PAC ID: 1254337918
Enrollment ID: I20061020000130
Provider NameTara Bauman
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1649311150
PECOS PAC ID: 5395802953
Enrollment ID: I20090325000775
Provider NameMichael Brendan Osullivan
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1962547901
PECOS PAC ID: 2163555046
Enrollment ID: I20100728001141
Provider NameDavid J Mair
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1083655898
PECOS PAC ID: 7517130057
Enrollment ID: I20111028000543
Provider NameChristina Franklin
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1568748291
PECOS PAC ID: 6709053606
Enrollment ID: I20120117000862
Provider NameJaneen M Montgomery-peterson
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1831337120
PECOS PAC ID: 6406016054
Enrollment ID: I20120320000223
Provider NameJudy K Brunsgaard
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1306115969
PECOS PAC ID: 7911162490
Enrollment ID: I20120709000031
Provider NameJustin T Coulter
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1992940746
PECOS PAC ID: 6608021258
Enrollment ID: I20130305000120
Provider NameJeanne Bailey
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1306971213
PECOS PAC ID: 2567607930
Enrollment ID: I20130408000247
Provider NameRebel Krista Gustafson
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1407061047
PECOS PAC ID: 4789804899
Enrollment ID: I20141013000072
Provider NameNatalie A Tobeck
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1427415082
PECOS PAC ID: 1153617162
Enrollment ID: I20160901001944
Provider NameGladys Ayiera Ndege
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659045391
PECOS PAC ID: 7719385293
Enrollment ID: I20211014000025
Provider NameDaniel O Moegi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508534751
PECOS PAC ID: 2264821610
Enrollment ID: I20211105001387
Provider NameHulda M Mosiori
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528673779
PECOS PAC ID: 0749670644
Enrollment ID: I20211208002767
Provider NameBrooke Resch
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1710507934
PECOS PAC ID: 5193142784
Enrollment ID: I20230616000902
Provider NameLuke Knutson
Provider TypePractitioner - Marriage And Family Therapist
Provider IdentifiersNPI Number: 1376759464
PECOS PAC ID: 4082069620
Enrollment ID: I20231218004118
Provider NameMatthew Skinner
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1588131577
PECOS PAC ID: 2365898806
Enrollment ID: I20240507002312

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.