Eldon James Brue, PH.D., LP, LMFT

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP2327 Issued in MN

Practice address

1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786

Phone

(651) 628-9566

Fax

(651) 628-0411

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1154354926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "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": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUE",
        "first_name": "ELDON",
        "middle_name": "JAMES",
        "credential": "PH.D., LP, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "0642",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP2327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090547000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lachelle Denise Brown
• Molly Brown
• Nanette Lousie Brown, MA, LP
• Timothy Richard Brustad, L.A.D.C.
• Paul Michael Thorsen Buck, D.D.S., M.D.
• Chesley Ann Buenger, LADC, LPCC
• Pamela Marie Bull, M.A, LPCC
• Scott Carl Burgi, MA

• Clinical Psychologist in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.