Active NPI
Nicholas P Woodruff-Sims
- Professional Counselor
- New Brighton, MN
National Provider Identifier
1699476259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 03300
- Practice address
- 101 30TH Ave NW
New Brighton, MN 55112-3116 - Phone
- (773) 456-9616
- NPI assigned
- Mar 10, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 03300 | MN | Primary |
Addresses
Primary practice location
101 30TH Ave NW
New Brighton, MN 55112-3116
Mailing address
7525 Mitchell Rd Ste 100
Eden Prairie, MN 55344-1900
Phone (612) 924-3807
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03300 | MN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777248000000",
"number": "1699476259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7525 MITCHELL RD STE 100",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553441900",
"telephone_number": "612-924-3807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 30TH AVE NW",
"city": "NEW BRIGHTON",
"state": "MN",
"postal_code": "551123116",
"telephone_number": "773-456-9616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODRUFF-SIMS",
"first_name": "NICHOLAS",
"middle_name": "P",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-10",
"last_updated": "2026-04-27",
"certification_date": "2026-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "03300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Brighton, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.