Active NPI
Teal Nelson, LAC
- Addiction (Substance Use Disorder) Counselor
- Minot, ND
National Provider Identifier
1184235053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1796
- Practice address
- 515 19TH Ave SE
Minot, ND 58701-6634 - Phone
- (701) 837-4989
- Fax
- (701) 837-9660
- NPI assigned
- Aug 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1796 | ND | Primary |
Addresses
Primary practice location
515 19TH Ave SE
Minot, ND 58701-6634
Mailing address
515 19TH Ave SE
Minot, ND 58701-6634
Phone (701) 837-4989
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1796 | ND | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597276800000",
"number": "1184235053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 19TH AVE SE",
"city": "MINOT",
"state": "ND",
"postal_code": "587016634",
"telephone_number": "701-837-4989",
"fax_number": "701-837-9660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 19TH AVE SE",
"city": "MINOT",
"state": "ND",
"postal_code": "587016634",
"telephone_number": "701-837-4989",
"fax_number": "701-837-9660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "TEAL",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-13",
"last_updated": "2020-08-13",
"certification_date": "2020-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "ND",
"license": "1796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.