Active NPI
John Brose, LP, LMFT, ADC
- Addiction (Substance Use Disorder) Counselor
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 300760
- Practice address
- 3100 W Lake St
Suite 210
Minneapolis, MN 55416-4527 - Phone
- (612) 925-6033
- Fax
- (612) 925-8496
- NPI assigned
- Dec 8, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 300760 | MN | Primary |
| Clinical Psychologist | 103TC0700X | LP1349 | MN | |
| Marriage & Family Therapist | 106H00000X | 719 | MN |
Addresses
Primary practice location
3100 W Lake St
Suite 210
Minneapolis, MN 55416-4527
Mailing address
3100 W Lake St
Suite 210
Minneapolis, MN 55416-4527
Phone (612) 925-6033
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 302943 | Other | MN | USA NETWORK |
| 6120000 | Other | MN | MEDICA CHOICE |
| HP19953 | Other | MN | HEALTHPARTNERS |
| 10183C154 | Other | MN | UCARE |
| 94374 | Other | MN | OPTUM |
| 68740BR | Other | MN | BCBS |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3100 W Lake St
Suite 210
Minneapolis, MN 55416-4510
3100 W Lake St
Suite 210
Minneapolis, MN 55416-4597
Phone (612) 925-6033
4027 County Rd
Suite 25
St Louis Park, MN 55416-4119
Phone (612) 925-6033
4240 Park Glen Rd
St Louis, MN 55416-4758
Phone (612) 925-6033
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 300760 | MN | MD | Addiction (Substance Use Disorder) Counselor |
| 719 | MN | MD | Professional Counselor |
| 1606 | MN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Clinic of Psychology Inc | Current | Accepting new patients |
Locations
4240 Park Glen Rd
St Louis Park, MN 55416
Phone (612) 925-6033
4027 County Road 25
St Louis Park, MN 55416
Phone (612) 925-6033
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- St Louis Park, MN
- NPI 1588741292
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1871652263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 W LAKE ST",
"address_2": "SUITE 210",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554164527",
"telephone_number": "612-925-6033",
"fax_number": "612-925-8496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 W LAKE ST",
"address_2": "SUITE 210",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554164527",
"telephone_number": "612-925-6033",
"fax_number": "612-925-8496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROSE",
"first_name": "JOHN",
"credential": "LP, LMFT, ADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-08",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "300760",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP1349",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "719",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "USA NETWORK",
"identifier": "302943",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA CHOICE",
"identifier": "6120000",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP19953",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "10183C154",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTUM",
"identifier": "94374",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "68740BR",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.