Individual provider Active NPI

Amber Rai Whelan, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Bemidji, MN
National Provider Identifier
1356942452
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
305791 Issued in MN
Practice address
403 4TH St NW Ste 300
Bemidji, MN 56601-3196
Phone
(218) 444-5155
Fax
(218) 333-3921
NPI assigned
Nov 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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 305791 MN Primary

Addresses

Primary practice location

403 4TH St NW Ste 300
Bemidji, MN 56601-3196

Mailing address

403 4TH St NW Ste 300
Bemidji, MN 56601-3196
Phone (218) 444-5155

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
305791MNMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1356942452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 4TH ST NW STE 300",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013196",
            "telephone_number": "218-444-5155",
            "fax_number": "218-333-3921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 4TH ST NW STE 300",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013196",
            "telephone_number": "218-444-5155",
            "fax_number": "218-333-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHELAN",
        "first_name": "AMBER",
        "middle_name": "RAI",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.