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Deactivated NPI 1922057694 Deactivated / Inactive NPI Male Practitioner

Dr. Bruce C Mcnickle , PHD LP

Psychologist - Counseling • St Cloud, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Bruce Mcnickle has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 09, 2006
NPI Deactivation Date June 01, 2024
Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Bruce Mcnickle, PHD LP was a registered Psychologist - Counseling practicing in St Cloud, MN. Throughout an active medical career spanning 18 years, Dr. Mcnickle provided care at the practice location at 1900 CENTRACARE CIRCLE until profile deactivation on 2024-06-01.

Practice Location & Contact Primary Location

Practice Address

1900 Centracare Circle
Centracare Health Plaza

St Cloud, MN 56303

Telephone 3202294977
Fax 3206567058
Associated Practice Facility / Clinic
🏢 St. Cloud Hospital Facility NPI 1013966175

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Counseling in St Cloud, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 24.4 Yrs
Regional Practice Density
2 Specialists

Practicing in St Cloud, MN (419 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist - Counseling Primary Specialty

NUCC Taxonomy Code: 103TC1900X

State License MN LP1975

A psychologist who specializes in general practice and health service. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well-being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

17 Associated Practitioners
Dr. Brad Kuhlman , PHD LP

Psychologist - Clinical

NPI 1013967173

PHDLP

Dee Vang

Psychologist

NPI 1316893597
Dr. Dean Watkins , MD

Psychiatry & Neurology - Psychiatry

NPI 1326097858

Doctor of Medicine (M.D.)

Jean Kirk , APRN CNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1346616281

Advanced Practice Registered Nurse - Certified Nurse Practitioner

Chad Weisser , LADC

Counselor - Addiction (Substance Use Disorder)

NPI 1346801065

Licensed Alcohol and Drug Counselor

Lindsay Anderson , PMHCNS-BC

Clinical Nurse Specialist - Psychiatric/Mental Health, Child & Adolescent

NPI 1477849222

PMHCNSBC

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 01, 2024

Record deactivated on June 01, 2024

NPI Profile Active January 10, 2008

NPI status registered as active in NPPES database

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Updated Practice Location January 10, 2008

Registered at 1900 CENTRACARE CIRCLE, CENTRACARE HEALTH PLAZA, ST CLOUD, MN 56303 (Tel: 3202294977)

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Updated Business Mailing Address January 10, 2008

Registered at 1406 6TH AVE N, ST CLOUD, MN 56303 (Tel: 3202512700)

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Provider Name / Credentials Updated January 10, 2008

Recorded as BRUCE MCNICKLE, PHD LP

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 10, 2008

Psychologist (License #LP1975 in MN)

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Initial NPI Registration & Enumeration May 09, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1922057694
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 09, 2006
Last Update: January 10, 2008
Deactivation Date: June 01, 2024

Mailing Address

1406 6th Ave N

St Cloud, MN 56303

Phone: 3202512700

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.