Bruce Lawrence Cross, LMFT
Individual provider Active NPI Marriage & Family Therapist · New Hope, MN
NPI 1861579567 · NPPES record last updated Nov 28, 2023
Key facts
- NPI
- 1861579567
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 846 (MN)
- Practice address
- 5555 Boone Ave N
New Hope, MN 55428-3636 - Phone
- (651) 774-0011
- Fax
- (651) 774-0606
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240122003319 | MN | Practitioner - Marriage and Family Therapist | 0446602841 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| People Incorporated | Current |
Accepting new patients | |
| People Incorporated | Current |
Accepting new patients | |
| Lakes Area Human Services, Inc. | Past | Accepting new patients |
Locations
1930 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 427-7964
2120 Park Ave
Minneapolis, MN 55404
Phone (612) 872-2000
5555 Boone Ave N
New Hope, MN 55428
Phone (763) 331-3033
317 York Ave
Saint Paul, MN 55130
Phone (651) 771-0286
3000 Ames Crossing Rd
Ste 600
Saint Paul, MN 55121
Phone (651) 288-3467
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 846 | MN | Yes |
Addresses
Primary practice location
5555 Boone Ave N
New Hope, MN 55428-3636
Mailing address
3000 Ames Crossing Rd Ste 600
Eagan, MN 55121-2519
Phone (651) 774-0011
Other practice location 1
882 S.W. 15th Street
Forest Lake, MN 55025
Phone (651) 464-2194
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 305-022-0000 | Medicaid | MN |
Other providers in New Hope, MN
- William Arthur Cote
- Allison Cox
- Jesse Cramer
- Rachel Cramer
- Jessica Crews
- D Light Transportation LLC
- Dandelion Spirit Psychotherapy, LLC
- Adrianne Ellen Danielson
- Kathy Clark Dansberry
- Rebecca Dantzler
All providers in New Hope, MN · Marriage & Family Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.