NPIMap

Organization Active NPI

Christian Recovery Center

Doing business as Christian Recovery Counseling

  • Psychologist
  • Golden Valley, MN
National Provider Identifier
1003879164
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
CHRISTIAN RECOVERY CENTER
Doing business as
Christian Recovery Counseling
Practice address
8441 Wayzata Blvd. Ste 160
Golden Valley, MN 55426
Phone
(763) 566-0088
Fax
(763) 566-0089
NPI assigned
Apr 10, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Lisa McDonald
Title
Executive Director
Phone
(763) 231-7602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X MN Primary

Addresses

Primary practice location

8441 Wayzata Blvd. Ste 160
Golden Valley, MN 55426

Mailing address

8441 Wayzata Blvd. Ste 160
Golden Valley, MN 55426
Phone (763) 566-0088

Other names 1

  • Christian Recovery Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060215000110 MN Part B Supplier - Clinic/Group Practice 9638184468 Receives reassigned benefits from 13 practitioners
Practice locations: Golden Valley, MN

National Provider Directory

National Provider Directory
Tax ID family
Christian Recovery Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6120 Earle Brown Dr
Ste 200
Minneapolis, MN 55430
Phone (763) 566-0088

8401 Wayzata Blvd
Ste 340
Minneapolis, MN 55426
Phone (763) 556-0088

8441 Wayzata Blvd
Ste 160
Minneapolis, MN 55426
Phone 7635660088 ext. 113

514 Saint Peter St
Ste 290
Saint Paul, MN 55102
Phone (763) 566-0088

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1003879164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8441 WAYZATA BLVD. STE 160",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "55426",
            "telephone_number": "763-566-0088",
            "fax_number": "763-566-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8441 WAYZATA BLVD. STE 160",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "55426",
            "telephone_number": "763-566-0088",
            "fax_number": "763-566-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "763-231-7602",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christian Recovery Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.