HALEY CARLOCK (NPI# 1013364199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013364199 |
| Entity Type | Individual |
| Full Name | HALEY CARLOCK |
| Credential | DNP, PMHNP-BC |
| Practice Address |
1155 Ford Rd Suite B St Louis Park MN 55426-1099 |
| Mailing Address |
3100 W Lake St Suite 210 Minneapolis MN 55416-4527 |
| Practice Telephone | 9523781800 |
| Practice Fax Number | 9523781714 |
| Mailing Telephone | 6129256033 |
| Mailing Fax Number | 6129258496 |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2017-04-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | R 197063-4 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
CNP 4630 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1155 FORD RD SUITE B |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55426-1099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154694982 | Clyde Stephens IIi | Pharmacist | 1155 Ford Rd, St Louis Park, MN 55426-1099 | 2012-02-09 |
| 1891309969 | Loveline N Ngu | Nurse Practitioner | 1155 Ford Rd, St Louis Park, MN 55426-1099 | 2020-09-04 |
| 1194167643 | Muriel Denise Philipp | Nurse Practitioner | 1155 Ford Rd, Suite B, St Louis Park, MN 55426-1099 | 2013-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821657545 | Big Brain Concussion Recovery & Chiropractic Pa | Chiropractor | 3313 Republic Ave., St. Louis Park, MN 55426 | 2019-06-06 |
| 1912485095 | Daniel Raies | Optometrist | 8900 Minnesota 7, St Louis Park, MN 55426 | 2018-08-01 |
| 1649756040 | Wayside House, Inc. | Clinic/Center | 1349 Jersey Ave S, St. Louis Park, MN 55426 | 2018-07-18 |
| 1104302884 | Superior Caregivers, LLC | In Home Supportive Care | 1319 Lancaster Ave., St. Louis Park, MN 55426 | 2018-07-16 |
| 1396234266 | Caitlin Kwiatkowski | Behavior Technician | 7010 Mn-7, St.louis Park, MN 55426 | 2018-05-07 |
| 1497244313 | Kelly Ann Clancey | Behavior Technician | 7010 Highway 2, Saint Louis Park, MN 55426 | 2018-05-07 |
| 1770072696 | Ashleigh Hakala | Behavior Technician | 7010 Highway 7 St. Louis Park Mn 55426, St. Louis Park, MN 55426 | 2018-05-07 |
| 1689181521 | Glenda Miles | Registered Nurse | 7316 Cedar Lake Road, Apt 8, St Louis Park, MN 55426 | 2017-12-31 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1447775549 | Belinda Sue Bliss | Marriage & Family Therapist | 3301 Decatur Lane, Saint Louis Park, MN 55426 | 2017-08-09 |
| Find all providers in zip 55426 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427601483 | Angela M Melland | Nurse Practitioner | 1550 Utica Ave S Ste 450, St Louis Park, MN 55416-3678 | 2019-07-18 |
| 1891309969 | Loveline N Ngu | Nurse Practitioner | 1155 Ford Rd, St Louis Park, MN 55426-1099 | 2020-09-04 |
| 1811537632 | Tatum Karos | Nurse Practitioner | 4027 County Road 25, St Louis Park, MN 55416-2629 | 2020-01-09 |
| 1497283253 | John Leland Mckinley | Nurse Practitioner | 3525 Monterey Dr, St Louis Park, MN 55416 | 2017-05-24 |
| 1194167643 | Muriel Denise Philipp | Nurse Practitioner | 1155 Ford Rd, Suite B, St Louis Park, MN 55426-1099 | 2013-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234435 | Hawa Warsame Ali | Nurse Practitioner | 2650 Portland Ave, Minneapolis, MN 55407-1011 | 2020-10-27 |
| 1962009548 | Emily Ongaga | Nurse Practitioner | 43 10 Parkview Circle, Anoka, MN 55303 | 2020-10-06 |
| 1811504038 | Rita Jane Giglio | Nurse Practitioner | 201 Stade Ln, Fairmont, MN 56031-3227 | 2020-09-30 |
| 1568077725 | Linda Mongare | Nurse Practitioner | 3659 Tower Pond Dr, Anoka, MN 55303-8302 | 2020-09-14 |
| 1366056806 | Associates In Mental Health and Addiction Services. P.l.l.c | Nurse Practitioner | 166 W 3rd St Ste 202, Winona, MN 55987-6591 | 2020-09-02 |
| 1891308813 | Chelsey Paulson | Nurse Practitioner | 228 Krays Mill Rd, Cold Spring, MN 56320-4563 | 2020-08-28 |
| 1417560681 | Amy Engle | Nurse Practitioner | 1125 Se 8th Street, Willmar, MN 56201 | 2020-08-28 |
| 1609488964 | Heather Mantsch | Nurse Practitioner | 1900 Silver Lake Rd Nw Ste 100, New Brighton, MN 55112-1786 | 2020-08-18 |
| 1326659210 | Monsurat Oluwa-okougbo | Nurse Practitioner | 1565 11th Ave, Newport, MN 55055-1650 | 2020-08-13 |
| 1629687124 | Justin Robert Wirth | Nurse Practitioner | 4801 Veterans Dr # 111, Saint Cloud, MN 56303-2015 | 2020-07-30 |
| Find all providers with the same taxonomy | ||||
| City | ST LOUIS PARK |
| Zip Code | 55426 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.