Tyler S Bluske, SAC-IT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

20331 Issued in WI

Practice address

300 4TH St N
La Crosse, WI 54601-3228

Phone

(608) 792-5964

Fax

(608) 785-6122

NPI assigned

Aug 10, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• County of la Crosse

  • Community/Behavioral Health Agency
  • La Crosse, WI
  • NPI 1366508897
  NPD (past)

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1114600640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 4TH ST N",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546013228",
            "telephone_number": "608-792-5964",
            "fax_number": "608-785-6122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 4TH ST N",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546013228",
            "telephone_number": "608-792-5964",
            "fax_number": "608-785-6122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUSKE",
        "first_name": "TYLER",
        "middle_name": "S",
        "credential": "SAC-IT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "20331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol B. Bloom, PT
• Lisa Ann Bloom
• Kimberly J Bloss, COTA
• Lydia Blum
• Kathryn Bluske, PA-C
• Anika Bly
• Robert L Bobenmoyer
• Joseph Bodnar, MS
• Sigurdur Bodvarsson, M.D.
• Michael Edward Boehm, LPC

• Addiction (Substance Use Disorder) Counselor in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.