MEDICARE: JOHN CRECCA JR. LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	5660	MN

General Provider Information

NPI Number	:	1942836358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN CRECCA JR. LPCC

Provider Business Mailing Address
First Line	:	15160 FOLIAGE AVE STE 140
Second Line	:
City	:	APPLE VALLEY
State	:	MN
Zip	:	55124-5903
Country	:	US
Telephone Number	:	651-365-8298
Fax Number	:	652-454-3492

Provider Business Practice Location Address
First Line	:	15160 FOLIAGE AVE STE 140
Second Line	:
City	:	APPLE VALLEY
State	:	MN
Zip	:	55124-5903
Country	:	US
Telephone Number	:	651-365-8298
Fax Number	:	652-454-3492

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2020
Last Update Date	:	06/16/2026

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Directions to “ JOHN CRECCA JR. LPCC” Practice Location

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