Brady Pieper

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

NPI 1164950796 · NPPES record last updated Mar 17, 2018

Key facts

NPI
1164950796
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
304657 (MN)
Practice address
266 Henrietta Ave N
Park Rapids, MN 56470-2155
Phone
(218) 252-2785
NPI assigned
May 26, 2017
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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
304657MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Center of Natural Healing, PLLC Past Accepting new patients
A Better Connection, Inc. Past
since Mar 8, 2016
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 304657 MN Yes

Addresses

Primary practice location

266 Henrietta Ave N
Park Rapids, MN 56470-2155

Mailing address

266 Henrietta Ave N
Park Rapids, MN 56470-2155

Other practice location 1

266 Henrietta Ave N
Park Rapids, MN 56470-2155
Phone (218) 252-2785

Other identifiers

IdentifierTypeStateIssuer
61604OtherMNPRIMEWEST HEALTH PLAN
MNMCDMedicaidMN
SB720OtherMNBCBS

Other providers in Park Rapids, MN

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

Sources for this page

Verify at the official NPI Registry.