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LIFE ESSENTIALS PSYCHOLOGY LLC
NPI 1124572235
Clinic/Center - Mental Health (Including Community Mental Health Center) in Andover, MN

Active since August 05, 2016
13750 CROSSTOWN DR NW STE 10, ANDOVER, MN 55304(763) 317-8255(855) 913-2522 Get Directions Write a Review

NPPES record last updated: October 10, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 10, 2025, Mar 22, 2025, Feb 28, 2022 and 4 more (7 updates tracked since 2017).

About Life Essentials Psychology Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFE ESSENTIALS PSYCHOLOGY LLC (NPI 1124572235) is a healthcare organization registered as a mental health (including community mental health center) in Andover, Minnesota and active in the NPI registry since August 2016. The organization lists Thao-ha Phan, Member, as its authorized official.

NPPES Registry Identity

NPI1124572235
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameLIFE ESSENTIALS PSYCHOLOGY LLC
Location Address13750 CROSSTOWN DR NW STE 10Andover, MN 55304-5853
Mailing Address13750 Crosstown Dr Nw Ste 10Andover, MN 55304-5853 · (763) 317-8255 · Fax (855) 913-2522
Phone(763) 317-8255
Fax(855) 913-2522
Organization SubpartNo
Authorized OfficialThao-ha PhanMember · (763) 317-8255
Enumeration DateAugust 5, 2016
Last NPPES UpdateOctober 10, 20257 updates tracked since enumeration
NPPES CertifiedOctober 10, 2025
✔ NPI 1124572235 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
13750 CROSSTOWN DR NW STE 10, Andover, MN 55304
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Other Identifiers 1

Medicaid1124572235MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Life Essentials Psychology Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Life Essentials Psychology LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Thao-Ha Phan, MA, LMFT, LADC
Marriage and Family Therapist
NPI 1477919025
13750 CROSSTOWN DR NW STE 10
Andover, MN 55304
(763) 317-8255
✔ PECOS✔ Accepts MedicareSame address
Kurt Sayers, MA, LPCC
Mental Health Counselor
NPI 1649623083
13750 CROSSTOWN DR NW STE 10
Andover, MN 55304
(763) 317-8255
✔ PECOS✔ Accepts MedicareSame address
Kimberley Wobschall, MA, LMFT
Marriage and Family Therapist
NPI 1003232638
13750 CROSSTOWN DR NW STE 10
Andover, MN 55304
(763) 317-8255
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Life Essentials Psychology LLC's NPI number?

The NPI number for Life Essentials Psychology LLC is 1124572235. It was assigned to this organization in the NPPES registry on August 5, 2016.

Where is Life Essentials Psychology LLC located?

Life Essentials Psychology LLC is located at 13750 Crosstown Dr NW Ste 10, Andover, MN 55304. The listed phone number is (763) 317-8255.

What is Life Essentials Psychology LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Is Life Essentials Psychology LLC enrolled in Medicare?

Yes. Life Essentials Psychology LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Life Essentials Psychology LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Life Essentials Psychology LLC, in Marriage and Family Therapist and Mental Health Counselor. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Life Essentials Psychology LLC accept?

Health plans from HealthPartners list Life Essentials Psychology LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Life Essentials Psychology LLC was last updated on October 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.