MR. WADE ROLLIN CRANDALL - NPI 1649510587 - Counselor in Coon Rapids, MN

Q: What is Wade Crandall's NPI number?

The NPI number for Wade Crandall is 1649510587. It was assigned to this individual provider in the NPPES registry on February 28, 2013. The provider is also known as Mr. Wade Rollin Crandall Lpcc.

Q: What is Wade Crandall's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Wade Crandall was last updated on February 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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About Mr. Wade Rollin Crandall NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. WADE ROLLIN CRANDALL (NPI 1649510587) is an individual counselor in Coon Rapids, Minnesota, licensed in Minnesota (CC00541) and active in the NPI registry since February 2013. He is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1649510587

Entity TypeIndividualMale

Primary Taxonomy101Y00000X

Provider Legal NameMR. WADE ROLLIN CRANDALL

Location Address3833 COON RAPIDS BLVD NW STE 120Coon Rapids, MN 55433-2599

Mailing Address1900 Silver Lake Rd NwNew Brighton, MN 55112-1786 · (651) 628-9566 · Fax (651) 628-0411

Phone(763) 767-3350

Fax(763) 767-0912

Sole ProprietorYes

Medical School CMSOtherGraduated 2010

Enumeration DateFebruary 28, 2013

Last NPPES UpdateFebruary 7, 2019

✔ NPI 1649510587 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in MN · CC00541

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

3833 COON RAPIDS BLVD NW STE 120, Coon Rapids, MN 55433

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Other Names 1

Professional Name (2)Mr. Wade Rollin Crandall Lpcc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Wade Rollin Crandall is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7315382413

PECOS Enrollment IDI20240228003536

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ABIGAIL FLETCHER

Counselor (Professional)