Individual provider Active NPI

Brian Michael Teuber, LADC

  • Addiction (Substance Use Disorder) Counselor
  • New Brighton, MN
National Provider Identifier
1215574652
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
301383 Issued in MN
Practice address
1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112
Phone
(651) 628-9566
Fax
(651) 628-0411
NPI assigned
Dec 4, 2019
Last updated
Dec 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 301383 MN Primary

Addresses

Primary practice location

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112

Mailing address

22811 Palisade St NE
East Bethel, MN 55005-9770
Phone (763) 413-3121

Other practice location 1

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112
Phone (651) 628-9566

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

LicenseStateTypeSpecialty
301383MNMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1215574652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22811 PALISADE ST NE",
            "city": "EAST BETHEL",
            "state": "MN",
            "postal_code": "550059770",
            "telephone_number": "763-413-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Silver Lake Rd NW Ste 110",
            "address_purpose": "LOCATION",
            "city": "New Brighton",
            "state": "MN",
            "postal_code": "55112",
            "country_code": "US",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEUBER",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-04",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "301383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brighton, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.