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Roy Haddad , LPCC, LADC

Counselor β€’ Bloomington, MN

Active NPI 1508479700 Individual Practitioner Male Practitioner
Practice location in NPPES

8120 Penn Ave S Ste 500u
Bloomington, MN 554311367

Call 9522450369 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

8120 Penn Ave S Ste 500u

Bloomington, MN 554311367

Telephone 9522450369
Fax 9525165282
Organization at the Same NPPES Address or Phone
Cedar Serenity Llc Facility NPI 1669169314

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2020

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Bloomington and Minnesota

12 active clinicians are listed under Counselor with a practice address in Bloomington, MN (450 in Minnesota).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Bloomington

8.3% of these 12 clinicians have the CMS telehealth indicator.

8.3% of these 12 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-07-19
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Minnesota Board of Medical Practice.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
000000 (MN)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location July 19, 2023

Registered at 8120 PENN AVE S STE 500U, BLOOMINGTON, MN 554311367 (Tel: 9522450369)

πŸ“
Updated Business Mailing Address July 19, 2023

Registered at 8120 PENN AVE S STE 500U, BLOOMINGTON, MN 554311367 (Tel: 9522450369)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 19, 2023

Counselor

πŸ‘€
Provider Name / Credentials Updated April 21, 2023

Recorded as ROY HADDAD, LPCC, LADC

βœ…
NPI Profile Active August 26, 2020

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 26, 2020

Registered at 5861 CEDAR LAKE RD, ST LOUIS PARK, MN 554161653 (Tel: 6122028703)

πŸ“
Business Mailing Address (Initial Record) August 26, 2020

Registered at 5861 CEDAR LAKE RD, ST LOUIS PARK, MN 55416 (Tel: 6122028703)

πŸ‘€
Provider Name / Credentials (Initial Record) August 26, 2020

Recorded as ROY HADDAD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 26, 2020

Counselor

🟒
Initial NPI Registration & Enumeration August 26, 2020

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1508479700
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 26, 2020
Last Update: July 19, 2023
Sole Proprietor: Yes

Mailing Address

8120 Penn Ave S Ste 500u

Bloomington, MN 554311367

Phone: 9522450369

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.