Individual provider Active NPI

Bruce David Ervin, MA, LMFT

  • Marriage & Family Therapist
  • Edina, MN
National Provider Identifier
1669598728
Registry record updated May 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1114 Issued in MN
Practice address
7400 Metro Blvd Ste 220
Edina, MN 55439-2321
Phone
(952) 345-4510
Fax
(952) 345-4518
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1114 MN Primary

Addresses

Primary practice location

7400 Metro Blvd Ste 220
Edina, MN 55439-2321

Mailing address

9952 Nord Rd
Bloomington, MN 55437-2339
Phone (952) 956-0076

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
I20240705000717 MN Practitioner - Marriage and Family Therapist 3375085558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ervin Counseling and Family Life Ministries PAGroup PAC ID 8820530009, 3 clinicians

Practice addresses (Care Compare)

7400 Metro Blvd
Suite 220
Edina, MN 55439-2321
Phone 95234545101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1114MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ervin Counseling and Family Life Ministries, P.a. Marriage & Family Therapist CurrentSince Aug 30, 2005 Accepting new patients

Locations

7200 France Ave S
Ste 338
Edina, MN 55435

7400 Metro Blvd
Ste 220
Minneapolis, MN 55439
Phone (952) 345-4510

Organizations & group practices 1

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714780800000",
    "number": "1669598728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9952 NORD RD",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554372339",
            "telephone_number": "952-956-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 METRO BLVD STE 220",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392321",
            "telephone_number": "952-345-4510",
            "fax_number": "952-345-4518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERVIN",
        "first_name": "BRUCE",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2024-05-04",
        "certification_date": "2024-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.