Active NPI
Nicole Hayes, BS, LADC
- Addiction (Substance Use Disorder) Counselor
- Coon Rapids, MN
National Provider Identifier
1255182572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 306978
- Practice address
- 11660 Round Lake Blvd NW
Coon Rapids, MN 55433-2638 - Phone
- (763) 767-3350
- Fax
- (763) 767-0912
- NPI assigned
- Mar 27, 2024
- 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 | 306978 | MN | Primary |
Addresses
Primary practice location
11660 Round Lake Blvd NW
Coon Rapids, MN 55433-2638
Mailing address
11660 Round Lake Blvd NW
Coon Rapids, MN 55433-2638
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 306978 | MN | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713916800000",
"number": "1255182572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11660 ROUND LAKE BLVD NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554332638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11660 ROUND LAKE BLVD NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554332638",
"telephone_number": "763-767-3350",
"fax_number": "763-767-0912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYES",
"first_name": "NICOLE",
"credential": "BS, LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-27",
"last_updated": "2024-04-24",
"certification_date": "2024-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "306978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.