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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BROOKE MIMMACK MA,LPCC
NPI 1750087615
Counselor - Professional in Baxter, MN

Active since February 02, 2023PECOS Enrolled
13045 FALCON DR STE 100, BAXTER, MN 56425(218) 829-9207 Get Directions Write a Review

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Brooke Mimmack Ma,lpcc NPPES

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

BROOKE MIMMACK MA,LPCC (NPI 1750087615) is an individual professional provider in Baxter, Minnesota, licensed in Minnesota (5644) and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1750087615
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameBROOKE MIMMACKCredential: MA,LPCC
Location Address13045 FALCON DR STE 100Baxter, MN 56425-4201
Mailing Address16300 Birchwood LnBrainerd, MN 56401-6184 · (218) 330-2175
Phone(218) 829-9207
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateFebruary 2, 2023
Last NPPES UpdateJune 29, 2026
NPPES CertifiedJune 29, 2026
✔ NPI 1750087615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MN · 5644
13045 FALCON DR STE 100, Baxter, MN 56425
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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)

Brooke Mimmack Ma,lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5395219620
PECOS Enrollment IDI20260708000216
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 20

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

EDWARD ALAN YURICK MSW, LGSW
Social Worker
13045 FALCON DR STE 100
BAXTER, MN 56425
Crow Wing County (844) 820-7391
KATHERINE ROSE HABERKORN LICSW
Social Worker (Clinical)
13045 FALCON DR STE 100
BAXTER, MN 56425
Crow Wing County (218) 829-9307
KELBY OLSON-RODEL
Social Worker (Clinical)
13045 FALCON DR STE 100
BAXTER, MN 56425
Crow Wing County (320) 219-9228
DR. KEVIN JAMES EDWARDS PH.D.
Psychologist (Clinical)
13045 FALCON DR STE 100
BAXTER, MN 56425
Crow Wing County (218) 829-9307
STEPHANIE SARAZINE PMHNP-BC, CNP
Psychiatry & Neurology (Psychiatry)
13045 FALCON DR STE 100
BAXTER, MN 56425
Crow Wing County (218) 829-9307
MRS. KARLI HELLER
Social Worker (Clinical)
13045 FALCON DR STE 100
BAXTER, MN 56425
Crow Wing County (218) 829-9307
SAMANTHA ANN HUGUELET CNS
Clinical Nurse Specialist (Psychiatric/Mental Health, Adult)
13045 FALCON DR STE 100
BAXTER, MN 56425
Crow Wing County (218) 829-9307
EVONNE SIROIS MSW, LICSW
Social Worker (Clinical)
13045 FALCON DR STE 100
BAXTER, MN 56425
Crow Wing County (218) 829-9307

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 Brooke Mimmack's NPI number?

The NPI number for Brooke Mimmack is 1750087615. It was assigned to this individual provider in the NPPES registry on February 2, 2023.

Where is Brooke Mimmack located?

Brooke Mimmack practices at 13045 Falcon Dr Ste 100, Baxter, MN 56425. The listed phone number is (218) 829-9207.

What is Brooke Mimmack's specialty?

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

Is Brooke Mimmack enrolled in Medicare?

Yes. Brooke Mimmack is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Brooke Mimmack was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 57 days 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.