Andrew Sudbeck, BS, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

302611 Issued in MN

Practice address

101 18TH Avenue North
Princeton, MN 55371

Phone

(763) 389-5080

Fax

(763) 631-9117

NPI assigned

Mar 27, 2012

Last updated

Mar 27, 2012By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1164798948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 1ST STREET",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "55371",
            "telephone_number": "763-389-5080",
            "fax_number": "763-631-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 18TH AVENUE NORTH",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "55371",
            "telephone_number": "763-389-5080",
            "fax_number": "763-631-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDBECK",
        "first_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "BS, LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADC",
            "identifier": "302611",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sterling Pointe Senior Living LLC
• Dale Mark Straus
• Heidi B Street, MD
• Amber Marie Strom, LPCC
• Teri Struthers, M.A.,NCC, LPCC
• Jake Neal Tarnowski, MD
• Morgan Taubel, RDN, LD
• Dedra Lee Theisen, RN
• Thomas L Nunnelee Inc (Princeton Vision Center)
• Bruce Thompson, PHARMD

• 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 Mar 27, 2012; 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.