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

LicenseStateTypeSpecialty
300369MNMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
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

Other providers in Montgomery, MN

All providers in Montgomery, MN · Addiction (Substance Use Disorder) Counselor in Minnesota

Sources for this page

Verify at the official NPI Registry.