Nikki Wait
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Glenwood, MN
NPI 1124491113 · NPPES record last updated Nov 12, 2015
Key facts
- NPI
- 1124491113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 304087 (MN)
- Practice address
- 100 17TH Ave NW
Ste 2
Glenwood, MN 56334-2159 - Phone
- (320) 634-3446
- Fax
- (320) 634-0384
- NPI assigned
- Nov 12, 2015
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 304087 | MN | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 304087 | MN | Yes |
Addresses
Primary practice location
100 17TH Ave NW
Ste 2
Glenwood, MN 56334-2159
Mailing address
100 17TH Ave NW
Ste 2
Glenwood, MN 56334-2159
Phone (320) 634-3446
Other providers in Glenwood, MN
- Unity Recovery LLC
- Jessica Mae Vanderhagen
- Vandesteeg & Larson Optometric Clinic PA
- Vandesteeg & Larson Optometric Clinic, PA
- Amanda Volesky
- Tayler Waldvogel
- Carl Stephen Wallin
- Duane Eric Westberg
- Western Prairie Human Services
- Luke Thomas Wilmes
All providers in Glenwood, 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 Nov 12, 2015. 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.