CARLY CRISTINE MCCORMACK LADC, LPCC
NPI 1700478625
Counselor - Mental Health in Coon Rapids, MN
About Carly Cristine Mccormack Ladc, Lpcc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CARLY CRISTINE MCCORMACK LADC, LPCC (NPI 1700478625) is an individual mental health provider in Coon Rapids, Minnesota, licensed in Minnesota (3936) and active in the NPI registry since February 2021. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Carly Cristine Mccormack Ladc, Lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Carly Mccormack reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Edina, MN 55439
- Reassigned Medicare billing, Minnesota enrollment
- Medicare enrollment name: Affinity Psychological Services PC
- 136 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Carly Mccormack's NPI number?
The NPI number for Carly Mccormack is 1700478625. It was assigned to this individual provider in the NPPES registry on February 11, 2021. The provider is also known as Carly Cristine Rutter.
Where is Carly Mccormack located?
Carly Mccormack practices at 12775 Swallow St NW, Coon Rapids, MN 55448. The listed phone number is (701) 850-7438.
What is Carly Mccormack's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Carly Mccormack enrolled in Medicare?
Yes. Carly Mccormack is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Carly Mccormack's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Carly Mccormack reassigns Medicare benefits to Affinity Psychological Services, P.C. (Edina, MN). The 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 Carly Mccormack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Carly Mccormack accept?
Health plans from HealthPartners list Carly Mccormack 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 Carly Mccormack was last updated on September 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Carly Cristine Mccormack, LADC, LPCC · NPI 1700478625
Mental Health provider in Coon Rapids, Minnesota. Individual provider, active in the CMS NPPES registry since February 11, 2021.
## Identity
- **NPI:** 1700478625 (Entity type: Individual)
- **Enumerated:** February 11, 2021
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 3936 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 12775 SWALLOW ST NW, Coon Rapids, MN 55448-2587
- **Phone:** (701) 850-7438
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Affinity Psychological Services, P.C. (NPI 1245610856, Edina, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 2, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1700478625) · Data from the CMS NPPES public registry.