David Eugene Sanderson, LADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Wadena, MN

NPI 1154840338 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1154840338
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
302384 (MN)
Practice address
12214 200TH St
Wadena, MN 56482-3124
Phone
(218) 631-3610
Fax
(218) 631-3917
NPI assigned
Sep 19, 2017
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
302384MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bell Hill Recovery Center Current
since Mar 12, 2024
Accepting new patients

Locations

12214 200th St
Wadena, MN 56482
Phone (218) 631-3610

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 302384 MN Yes

Addresses

Primary practice location

12214 200TH St
Wadena, MN 56482-3124

Mailing address

PO Box 206
Wadena, MN 56482-0206
Phone (218) 631-3610

Other providers in Wadena, MN

All providers in Wadena, MN · Addiction (Substance Use Disorder) Counselor in Minnesota

Sources for this page

Verify at the official NPI Registry.