Living Free Recovery Services, LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

830992-2-CDT Issued in MN

Legal business name

LIVING FREE RECOVERY SERVICES, LLC

Practice address

9201 75TH Avenue North
Brooklyn Park, MN 55428

Phone

(763) 315-7000

Fax

(763) 315-7177

NPI assigned

Jul 1, 2005

Last updated

Nov 1, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Treena Haase

Title

President

Phone

(763) 315-7174

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Living Word Christian Center DBA Living Free Recovery Services Former legal business name

Practitioners 3

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.

• Crysta Rochele Cadalbert, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Minneapolis, MN
  • NPI 1447084884
  NPD (past)
• Ashley Miller

  • Addiction (Substance Use Disorder) Counselor
  • Otsego, MN
  • NPI 1164001459
  NPD (past)
• Sean Brandon Miller

  • Marriage & Family Therapist
  • Brooklyn Park, MN
  • NPI 1073142725

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509494400000",
    "number": "1144227430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 75TH AVENUE NORTH",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "55428",
            "telephone_number": "763-315-7000",
            "fax_number": "763-315-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 75TH AVENUE NORTH",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "55428",
            "telephone_number": "763-315-7000",
            "fax_number": "763-315-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING FREE RECOVERY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-01",
        "last_updated": "2017-11-01",
        "status": "A",
        "authorized_official_last_name": "HAASE",
        "authorized_official_first_name": "TREENA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-315-7174"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "830992-2-CDT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251922400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "0C20LI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH - ADULT",
            "identifier": "8442759",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH- ASSESSMENT ONLY",
            "identifier": "8446051",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH - ADOLESCENT",
            "identifier": "8442760",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH - RELAPSE",
            "identifier": "8442761",
            "state": "FM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Living Word Christian Center DBA Living Free Recovery Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.