Individual provider Active NPI

Colin Gregory Cooper, LPCC

  • Professional Counselor
  • Bloomington, MN
National Provider Identifier
1134896384
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4841 Issued in MN
Practice address
1101 E 78TH St Ste 100
Bloomington, MN 55420-1402
Phone
(952) 234-8604
NPI assigned
Aug 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4841 MN Primary

Addresses

Primary practice location

1101 E 78TH St Ste 100
Bloomington, MN 55420-1402

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 628-9566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250319000719 MN Practitioner - Mental Health Counselor 9234651274 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4841MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Mar 1, 2025 Accepting new patients
Affinity Psychological Services, P.C. Mental Health CurrentSince Mar 9, 2026 Accepting new patients
Family Support Services Inc. Mental Health PastSince Aug 29, 2021 Accepting new patients

Locations

6600 France Ave S
Ste 425
Edina, MN 55435
Phone (952) 243-8300

1101 E 78th St
Ste 100
Minneapolis, MN 55420
Phone (952) 234-8604

13100 Wayzata Blvd
Ste 200
Minnetonka, MN 55305
Phone (952) 206-2040

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

5775 Wayzata Blvd
Ste 880
St Louis Park, MN 55416

1811 Weir Dr
Ste 270
Woodbury, MN 55125
Phone (651) 243-6087

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1134896384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E 78TH ST STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554201402",
            "telephone_number": "952-234-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "COLIN",
        "middle_name": "GREGORY",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-25",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "4841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.