NPIMap

Organization Active NPI

Christian Recovery Center

  • Counselor
  • Brooklyn Center, MN
National Provider Identifier
1831213420
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
CHRISTIAN RECOVERY CENTER
Practice address
6120 Earle Brown Dr
Suite 200
Brooklyn Center, MN 55430-2123
Phone
(763) 566-0088
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Julie A. Dewilde
Title
Psychotherapist
Phone
(763) 566-0088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

6120 Earle Brown Dr
Suite 200
Brooklyn Center, MN 55430-2123

Mailing address

3533 Ensign Ave N
New Hope, MN 55427-1725
Phone (763) 546-0152

National Provider Directory

National Provider Directory
Tax ID family
Christian Recovery Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831213420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 ENSIGN AVE N",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554271725",
            "telephone_number": "763-546-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 EARLE BROWN DR",
            "address_2": "SUITE 200",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302123",
            "telephone_number": "763-566-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEWILDE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "763-566-0088"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Center, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.