Individual provider Active NPI

Carolyn R Wiger, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Stillwater, MN
National Provider Identifier
1013508951
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
303293 Issued in MN
Practice address
14949 62ND St N
Stillwater, MN 55082-6132
Phone
(651) 430-6460
NPI assigned
Feb 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 303293 MN Primary

Addresses

Primary practice location

14949 62ND St N
Stillwater, MN 55082-6132

Mailing address

14949 62ND St N
Stillwater, MN 55082-6132
Phone (651) 430-6460

Other names 1

  • Carolyn Wiger Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
303293MNMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1013508951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14949 62ND ST N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826132",
            "telephone_number": "651-430-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14949 62ND ST N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826132",
            "telephone_number": "651-430-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGER",
        "first_name": "CAROLYN",
        "middle_name": "R",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "WIGER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Stillwater, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.