Nancy Marie Kaley, LADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Montgomery, MN
NPI 1013531318 · NPPES record last updated Jun 2, 2020
Key facts
- NPI
- 1013531318
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 300369 (MN)
- Practice address
- 202 1St St S
Montgomery, MN 56069-1602 - Phone
- (952) 303-9585
- NPI assigned
- Jun 2, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 300369 | MN | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | 300369 | MN | Yes |
Addresses
Primary practice location
202 1St St S
Montgomery, MN 56069-1602
Mailing address
13479 Carmody Dr
Eden Prairie, MN 55344-6718
Phone (612) 250-0075
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All providers in Montgomery, 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 Jun 2, 2020. 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.