Matthew Brandon Cruz, MA, LPCC, LADC | |
9600 Upland Ln N Ste 110, Maple Grove, MN 55369-4499 | |
(952) 993-6200 | |
Not Available |
Full Name | Matthew Brandon Cruz |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 9600 Upland Ln N Ste 110, Maple Grove, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851055818 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 305677 (Minnesota) | Secondary |
101YM0800X | Counselor - Mental Health | 3083 (Minnesota) | Primary |
Entity Name | Park Nicollet Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046 |
Mailing Address | Practice Location Address |
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Matthew Brandon Cruz, MA, LPCC, LADC 8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425-4516 Ph: () - | Matthew Brandon Cruz, MA, LPCC, LADC 9600 Upland Ln N Ste 110, Maple Grove, MN 55369-4499 Ph: (952) 993-6200 |
Sarah Nicole Olson Venning, LICSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 14500 99th Ave N, Maple Grove, MN 55369 Phone: 651-600-0342 | |
Daniel Knudson, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 13603 80th Cir N, Maple Grove, MN 55369 Phone: 763-274-3120 Fax: 763-274-3121 | |
Blake Malloy, Counselor Medicare: Not Enrolled in Medicare Practice Location: 13603 80th Cir N, Maple Grove, MN 55369 Phone: 763-274-3120 Fax: 763-274-3121 | |
Alysha Kvam, Counselor Medicare: Medicare Enrolled Practice Location: 12918 63rd Ave N, Maple Grove, MN 55369 Phone: 763-210-9966 | |
Barbara Wormington, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10650 County Road 81 Ste N, Maple Grove, MN 55369 Phone: 417-529-3250 | |
Martha Sepulveda, Counselor Medicare: Not Enrolled in Medicare Practice Location: 13603 80th Cir N, Maple Grove, MN 55369 Phone: 763-284-3706 Fax: 763-274-3121 | |
Kimberly Fothergill, Counselor Medicare: Not Enrolled in Medicare Practice Location: 13603 80th Cir N, Maple Grove, MN 55369 Phone: 763-274-3120 Fax: 763-274-3121 |