Individual provider Active NPI

Adam Thiel, LSW, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Saint Cloud, MN
National Provider Identifier
1346807393
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
305083 Issued in MN
Practice address
713 Anderson Ave
Saint Cloud, MN 56303-2048
Phone
(320) 229-3760
Fax
(320) 229-3762
NPI assigned
May 24, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 23736 MN
Addiction (Substance Use Disorder) Counselor 101YA0400X 305083 MN Primary

Addresses

Primary practice location

713 Anderson Ave
Saint Cloud, MN 56303-2048

Mailing address

713 Anderson Ave
Saint Cloud, MN 56303-2048
Phone (320) 229-3760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240326001093 MN Practitioner - Clinical Social Worker 0547607566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians

Practice addresses (Care Compare)

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
305083MNMDAddiction (Substance Use Disorder) Counselor
23736MNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St. Cloud Hospital Current Accepting new patients
St. Cloud Hospital CurrentSince Mar 1, 2024 Accepting new patients
St. Cloud Hospital CurrentSince Mar 1, 2024 Accepting new patients

Locations

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

713 Anderson Ave
Saint Cloud, MN 56303
Phone (320) 229-3760

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1346807393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 ANDERSON AVE",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032048",
            "telephone_number": "320-229-3760",
            "fax_number": "320-229-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 ANDERSON AVE",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032048",
            "telephone_number": "320-229-3760",
            "fax_number": "320-229-3762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEL",
        "first_name": "ADAM",
        "credential": "LSW, LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-24",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "23736",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.