Donna Wahlstrom

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

303084 Issued in MN

Practice address

105 6TH Ave S
Princeton, MN 55371-1819

Phone

(763) 308-0006

NPI assigned

Oct 24, 2014

Sex

Female

Sole proprietor

Yes

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.

• C & C Consulting Inc.

  • Community/Behavioral Health Agency
  • Princeton, MN
  • NPI 1053727289
  NPD (past)

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1144625708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 HARBOR ST",
            "city": "OGILVIE",
            "state": "MN",
            "postal_code": "563583621",
            "telephone_number": "320-272-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 6TH AVE S",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553711819",
            "telephone_number": "763-308-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLSTROM",
        "first_name": "DONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Urology Associates, LTD.
• Theodore P Vanerp, MD
• Steven Craig Vanhooser, DC
• Alaina Jean Verkinnes, MA CCC-SLP
• Abby Marie Vermilyea, PT, DPT
• Wal-Mart Stores Inc
• David A Waletzko, MD
• Walmart Inc.
• Mary Frances Ward, MA: CCC
• Maria Jeanne Werner, C.M.T.

• Addiction (Substance Use Disorder) Counselor in Princeton, MN
• Providers in Princeton, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.