Irene Callista Abide, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1900 Silver Lake Rd NW
New Brighton, MN 55112-1786

Phone

(651) 628-9566

NPI assigned

Jun 8, 2023

Last updated

Jun 8, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1205520509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 KELLY DR",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554273517",
            "telephone_number": "763-442-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABIDE",
        "first_name": "IRENE",
        "middle_name": "CALLISTA",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abc Home Medical Supply, Inc.
• Sagal A Abdi
• Kaltun Abdikarani, LSW
• Able Medical LLC (Raycam Medicals)
• Able Medical LLC
• Elizabeth Kay Abraham, NP
• Jennifer Abrahamson, M.A., L.P.C.
• Academy Contact Lens Clinic

• Addiction (Substance Use Disorder) Counselor in New Brighton, MN
• Providers in New Brighton, 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 Jun 8, 2023; 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.