Active NPI
Rowland V Betties, CADC III
- Addiction (Substance Use Disorder) Counselor
- Milwaukee, WI
National Provider Identifier
1396834842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 14355
- Practice address
- 2801 N. 4TH Street
Suite 139
Milwaukee, WI 53212-2711 - Phone
- (414) 264-4217
- Fax
- (414) 264-4218
- NPI assigned
- Oct 12, 2006
- Last updated
- Aug 21, 2009
- Sex
- Male
- 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 | 14355 | WI | Primary |
Addresses
Primary practice location
2801 N. 4TH Street
Suite 139
Milwaukee, WI 53212-2711
Mailing address
6400 Industrial Loop
Greendale, WI 53129-2452
Phone (414) 423-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39172700 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14355 | WI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250812800000",
"number": "1396834842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6400 INDUSTRIAL LOOP",
"city": "GREENDALE",
"state": "WI",
"postal_code": "531292452",
"telephone_number": "414-423-4100",
"fax_number": "414-423-4134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 N. 4TH STREET",
"address_2": "SUITE 139",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532122711",
"telephone_number": "414-264-4217",
"fax_number": "414-264-4218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETTIES",
"first_name": "ROWLAND",
"middle_name": "V",
"name_prefix": "Mr.",
"credential": "CADC III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2009-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "14355",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39172700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.