Individual provider Active NPI

Cris Roman, LMFT

  • Marriage & Family Therapist
  • Blaine, MN
National Provider Identifier
1922524156
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT.0001509 Issued in MN
Practice address
11182 Aberdeen St NE Unit a
Blaine, MN 55449-6031
Phone
(320) 455-1560
NPI assigned
Aug 18, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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 MFT.0001509 MN Primary

Addresses

Primary practice location

11182 Aberdeen St NE Unit a
Blaine, MN 55449-6031

Mailing address

11182 Aberdeen St NE Unit a
Blaine, MN 55449-6031
Phone (320) 455-1560

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

LicenseStateTypeSpecialty
MFT.0001509MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shoreview Mental Health Center, LLC PastSince Jul 12, 2016 Accepting new patients

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": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1922524156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11182 ABERDEEN ST NE UNIT A",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554496031",
            "telephone_number": "320-455-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11182 ABERDEEN ST NE UNIT A",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554496031",
            "telephone_number": "320-455-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "CRIS",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-18",
        "last_updated": "2025-03-11",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "MFT.0001509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.