Individual provider Active NPI

Debra A Adamus, CLINICAL SUBSTANCE A

  • Addiction (Substance Use Disorder) Counselor
  • Oconomowoc, WI
National Provider Identifier
1073727640
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
718132 Issued in WI
Practice address
418 E Wisconsin Ave
Oconomowoc, WI 53066
Phone
(414) 429-6403
Fax
(262) 354-0794
NPI assigned
May 10, 2007
Last updated
Jun 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 718132 WI Primary
Professional Counselor 101YP2500X 718-132 WI

Addresses

Primary practice location

418 E Wisconsin Ave
Oconomowoc, WI 53066

Mailing address

418 E Wisconsin Ave
Oconomowoc, WI 53066-3040
Phone (414) 429-6403

Other practice location 1

250 W Broadway Ste 2
Waukesha, WI 53186-4848
Phone (414) 429-6403

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
718132WIMDAddiction (Substance Use Disorder) Counselor
718-132WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Healing Arts & Counseling LLC Professional Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1073727640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 E WISCONSIN AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663040",
            "telephone_number": "414-429-6403",
            "fax_number": "262-354-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 E WISCONSIN AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "53066",
            "telephone_number": "414-429-6403",
            "fax_number": "262-354-0794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 W Broadway Ste 2",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531864848",
            "country_code": "US",
            "telephone_number": "414-429-6403",
            "fax_number": "262-354-0794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMUS",
        "first_name": "DEBRA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "CLINICAL SUBSTANCE A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "718132",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "718-132",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.