Active NPI
Safety Center Inc
- Clinical Psychologist
- Bloomington, MN
National Provider Identifier
1205095833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- SAFETY CENTER INC
- Practice address
- 10800 Lyndale Ave S Ste 75
Bloomington, MN 55420-0010 - Phone
- (952) 884-4882
- Fax
- (952) 884-0284
- NPI assigned
- Jun 9, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cynthia Bloom, MA, LPCC
- Title
- Director of Counseling
- Phone
- (952) 884-4882
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Psychologist | 103T00000X | |||
| Clinical Psychologist | 103TC0700X | Primary | ||
| Forensic Psychologist | 103TF0200X | |||
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | |||
| Psychoanalysis Psychologist | 103TP0814X | |||
| Group Psychotherapy Psychologist | 103TP2701X | |||
| Rehabilitation Psychologist | 103TR0400X | |||
| Marriage & Family Therapist | 106H00000X |
Addresses
Primary practice location
10800 Lyndale Ave S Ste 75
Bloomington, MN 55420-0010
Mailing address
10800 Lyndale Ave S Ste 75
Bloomington, MN 55420-0010
Phone (952) 884-4882
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 035866500 | Medicaid | MN | |
| 112323800 | Medicaid | MN | |
| 335847000 | Medicaid | MN | |
| 427098300 | Medicaid | MN |
National Provider Directory
National Provider Directory- Tax ID family
- DPS Transportation LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Non-emergency Medical Transport (VAN)
- Bloomington, MN
- NPI 1205033065
Locations
1216 W 96th St
Ste A
Bloomington, MN 55431
Phone (952) 884-4882
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212969600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1717372800000",
"number": "1205095833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10800 LYNDALE AVE S STE 75",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554200010",
"telephone_number": "952-884-4882",
"fax_number": "952-884-0284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10800 LYNDALE AVE S STE 75",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554200010",
"telephone_number": "952-884-4882",
"fax_number": "952-884-0284"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAFETY CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-06-09",
"last_updated": "2024-06-03",
"certification_date": "2024-06-03",
"status": "A",
"authorized_official_last_name": "BLOOM",
"authorized_official_first_name": "CYNTHIA",
"authorized_official_title_or_position": "DIRECTOR OF COUNSELING",
"authorized_official_telephone_number": "952-884-4882",
"authorized_official_credential": "MA, LPCC"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": true
},
{
"code": "103TF0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Forensic",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TP0814X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Psychoanalysis",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Group Psychotherapy",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TR0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Rehabilitation",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "035866500",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112323800",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "335847000",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "427098300",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.