Jennifer Jo Spatola, LAC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Cando, ND

NPI 1184906828 · NPPES record last updated Oct 27, 2022

Key facts

NPI
1184906828
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
1524 (ND)
Practice address
7448 68TH Ave NE
Cando, ND 58324-9485
Phone
(701) 968-2568
Fax
(701) 968-2560
NPI assigned
Sep 19, 2011
Sex
Female
Sole proprietor
No

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
1524NDMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1524 ND Yes

Addresses

Primary practice location

7448 68TH Ave NE
Cando, ND 58324-9485

Mailing address

7448 68TH Ave NE
Cando, ND 58324-9485
Phone (701) 968-2568

Other providers in Cando, ND

All providers in Cando, ND · Addiction (Substance Use Disorder) Counselor in North Dakota

Sources for this page

Verify at the official NPI Registry.