Alan A Abraham, ALCOHOL DRUG COUNSEL
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Virginia, MN
NPI 1013018480 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1013018480
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 301462 (MN)
- Practice address
- 626 S 13TH St
Detox Range Treatment Center
Virginia, MN 55792 - Phone
- (218) 741-9120
- Fax
- (218) 741-3170
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 301462 | MN | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Range Mental Health Center Inc | Past | Accepting new patients | |
| Range Mental Health Center Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 301462 | MN | Yes |
Addresses
Primary practice location
626 S 13TH St
Detox Range Treatment Center
Virginia, MN 55792
Mailing address
626 S 13TH St
Detox Range Treatment Center
Virginia, MN 55792
Phone (218) 741-9120
Other providers in Virginia, MN
All providers in Virginia, MN · Addiction (Substance Use Disorder) Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.