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KEVIN GORDON CARLSON LPCC, LADC
NPI 1205647740
Counselor - Professional in Fridley, MN

Active since January 15, 2025PECOS Enrolled
520 OSBORNE RD NE STE 120, FRIDLEY, MN 55432(763) 236-4300 Get Directions Write a Review

NPPES record last updated: February 3, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kevin Gordon Carlson Lpcc, Ladc NPPES

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

KEVIN GORDON CARLSON LPCC, LADC (NPI 1205647740) is an individual professional provider in Fridley, Minnesota, licensed in Minnesota (4790) and active in the NPI registry since January 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205647740
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameKEVIN GORDON CARLSONCredential: LPCC, LADC
Location Address520 OSBORNE RD NE STE 120Fridley, MN 55432-2718
Mailing Address2925 Chicago AveMinneapolis, MN 55407-1321 · (612) 262-9000
Phone(763) 236-4300
Sole ProprietorYes
Enumeration DateJanuary 15, 2025
Last NPPES UpdateFebruary 3, 2025
NPPES CertifiedFebruary 3, 2025
✔ NPI 1205647740 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MN · 4790
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 305394 (MN)
520 OSBORNE RD NE STE 120, Fridley, MN 55432
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kevin Gordon Carlson Lpcc, Ladc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NICOLE CAILEIGH ARTHUR M.D.
Psychiatry & Neurology (Psychiatry)
520 OSBORNE RD NE STE 120
FRIDLEY, MN 55432
Anoka County (763) 236-4300
RILEY JEROME PALMER PHD, LP
Clinical Neuropsychologist
520 OSBORNE RD NE STE 120
FRIDLEY, MN 55432
Anoka County (763) 236-4300
NICOLE STALOCH NP
Nurse Practitioner (Psychiatric/Mental Health)
520 OSBORNE RD NE STE 120
FRIDLEY, MN 55432
Anoka County (763) 236-4300
MIKAYLA GRACE BAKER THORN LPCC, LADC
Counselor (Professional)
520 OSBORNE RD NE STE 120
FRIDLEY, MN 55432
Anoka County (763) 236-4300
KATHERINE ANSCHUTZ LADC
Counselor (Addiction (Substance Use Disorder))
520 OSBORNE RD NE STE 120
FRIDLEY, MN 55432
Anoka County (763) 236-4371
NATHAN ERICKSON
Counselor (Addiction (Substance Use Disorder))
520 OSBORNE RD NE STE 120
FRIDLEY, MN 55432
Anoka County (763) 236-4572
MICHAEL CURRAN LADC
Counselor (Addiction (Substance Use Disorder))
520 OSBORNE RD NE STE 120
FRIDLEY, MN 55432
Anoka County (763) 236-4371
MEKENA COAKLEY MS, LADC, LPCC
Counselor (Mental Health)
520 OSBORNE RD NE STE 120
FRIDLEY, MN 55432
Anoka County (763) 236-4300

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 Kevin Carlson's NPI number?

The NPI number for Kevin Carlson is 1205647740. It was assigned to this individual provider in the NPPES registry on January 15, 2025.

Where is Kevin Carlson located?

Kevin Carlson practices at 520 Osborne Rd NE Ste 120, Fridley, MN 55432. The listed phone number is (763) 236-4300.

What is Kevin Carlson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kevin Carlson enrolled in Medicare?

Yes. Kevin Carlson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kevin Carlson was last updated on February 3, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.