BRYAN CLIFFORD BODROG (NPI# 1265900120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265900120 |
| Entity Type | Individual |
| Full Name | BRYAN CLIFFORD BODROG |
| Credential | LPCC |
| Practice Address |
550 County Road D W Ste 10 New Brighton MN 55112-3517 |
| Practice Telephone | 6516444022 |
| Mailing Telephone | 6516444022 |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2018-11-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
CC01044 | MN | Behavioral Health & Social Service Providers |
| Street Address |
550 COUNTY ROAD D W STE 10 |
| City | NEW BRIGHTON |
| State | MN |
| Zip Code | 55112-3517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932729704 | Owegio Wreh | Technician | 1405 Silver Lake Road Suite 15, New Brighton, MN 55112 | 2020-04-22 |
| 1205497435 | Silver Lake Smiles Family Dentistry | Clinic/Center | 2370 Palmer Drive, New Brighton, MN 55112 | 2019-06-27 |
| 1932766169 | Matthew Thomas Hanowski | Dentist | 2442 Mounds View Boulevard, Mounds View, MN 55112 | 2019-05-22 |
| 1437619988 | Marjean Diane Leary | Registered Nurse | 338 New Brighton Road, Apt, Suite, Bldg. (optional), New Brighton, MN 55112 | 2019-03-21 |
| 1558802728 | Krishna Katira | Student in an Organized Health Care Education/Training Program | 2442 County Hwy 10, Mounds View, MN 55112 | 2017-03-20 |
| 1245781608 | Evan Fredrick Lieberman | Counselor | 1900 Silver Lake Rd, Suite 110, New Brighton, MN 55112 | 2016-10-20 |
| 1093262065 | Ryan Zinken | Nurse Practitioner | 1900 Silver Lake Road, Suite 110, New Brighton, MN 55112 | 2016-09-07 |
| 1447703228 | Alison Glodek | Social Worker | 2543 17th St Nw, New Brighton, MN 55112 | 2016-07-28 |
| 1659728194 | Ge Vang Sr. | Driver | 2160 County Road E West #205, 2160 County Road E West #205, New Brighton, MN 55112 | 2016-05-14 |
| 1114373578 | Jessica Gapinski | Specialist/Technologist | 3900 Bethel Drive, Arden Hills, MN 55112 | 2016-05-04 |
| Find all providers in zip 55112 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942825690 | Barbara Lee Linko | Counselor | 826 3rd Ave, New Brighton, PA 15066-1915 | 2020-06-09 |
| 1275930349 | Maranda Mcclintock | Counselor | 211 Stuber Rd, New Brighton, PA 15066-3327 | 2014-12-04 |
| 1063734663 | Victoria Frye | Counselor | 900 Long Lake Rd Ste 160, New Brighton, MN 55112-6414 | 2010-02-23 |
| 1568543080 | Kathy Ann Dixon | Counselor | 1405 Silver Lake Rd Nw Ste 17, New Brighton, MN 55112-9309 | 2006-10-18 |
| 1174179998 | Olistica, Inc. | Counselor | 1405 Silver Lake Rd Nw Ste 17, New Brighton, MN 55112-9309 | 2019-08-16 |
| 1699242685 | Robert Henry | Counselor | 709 3rd Ave, New Brighton, PA 15066-1846 | 2018-10-28 |
| 1124579677 | Brenda Lea Nikkila | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2016-10-19 |
| 1083168314 | Julie Anne De Wilde | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2016-08-03 |
| 1295188324 | Rebecca Sanders | Counselor | 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112-1786 | 2016-07-13 |
| 1841642345 | Alexandria Wendlandt | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2016-07-07 |
| Find all providers in NEW BRIGHTON | ||||
| City | NEW BRIGHTON |
| Zip Code | 55112 |
Please comment or provide details below to improve the information on BRYAN CLIFFORD BODROG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.