Genevieve A Balajadia, MA, T-CADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Dubuque, IA

NPI 1073079679 · NPPES record last updated Feb 19, 2019

Key facts

NPI
1073079679
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
T18043 (IA)
Practice address
799 Main St Ste 110
Dubuque, IA 52001-6825
Phone
(563) 582-3784
Fax
(563) 582-4006
NPI assigned
Feb 19, 2019
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
T18043IAMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X T18043 IA Yes

Addresses

Primary practice location

799 Main St Ste 110
Dubuque, IA 52001-6825

Mailing address

799 Main St Ste 110
Dubuque, IA 52001-6825
Phone (563) 582-3784

Other identifiers

IdentifierTypeStateIssuer
2580MedicaidIA

Other providers in Dubuque, IA

All providers in Dubuque, IA · Addiction (Substance Use Disorder) Counselor in Iowa

Sources for this page

Verify at the official NPI Registry.