Individual
JOHN BROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LP, LMFT, ADC
Contact information
Practice address
3100 W LAKE ST, SUITE 210, MINNEAPOLIS, MN 55416-4527
(612) 925-6033
(612) 925-8496
Mailing address
3100 W LAKE ST, SUITE 210, MINNEAPOLIS, MN 55416-4527
(612) 925-6033
(612) 925-8496
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300760
MN
103TC0700X
Clinical Psychologist
LP1349
MN
106H00000X
Marriage & Family Therapist
719
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10183C154
UCARE
MN
01
—
302943
USA NETWORK
MN
01
—
6120000
MEDICA CHOICE
MN
01
—
68740BR
BCBS
MN
01
—
94374
OPTUM
MN
01
—
HP19953
HEALTHPARTNERS
MN
Enumeration date
12/08/2006
Last updated
09/11/2025
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