John Thomas Maclin Jr., LICENSED ALCOHOL DRU

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

301427 Issued in MN

Practice address

8500 Edinbrook Parkway #a
Brooklyn Park, MN 55443

Phone

(612) 462-0826

Fax

(763) 777-5685

NPI assigned

Jan 21, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1447497920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 EDINBROOK PARKWAY #A",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "55443",
            "telephone_number": "612-462-0826",
            "fax_number": "763-777-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 EDINBROOK PARKWAY #A",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "55443",
            "telephone_number": "612-462-0826",
            "fax_number": "763-777-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACLIN",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LICENSED ALCOHOL DRU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-21",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "301427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.