Active NPI
Paula R Eberhardt, LADC
- Addiction (Substance Use Disorder) Counselor
- Moorhead, MN
National Provider Identifier
1457969396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 305652
- Practice address
- 2405 8TH St S Ste 200
Moorhead, MN 56560-4200 - Phone
- (218) 382-1267
- Fax
- (218) 331-4867
- NPI assigned
- Jul 16, 2020
- 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 | 305652 | MN | Primary |
Addresses
Primary practice location
2405 8TH St S Ste 200
Moorhead, MN 56560-4200
Mailing address
12752 Everlasting Dr
Park Rapids, MN 56470-3282
Phone (218) 252-9905
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 |
|---|---|---|---|
| 305652 | 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": "1594857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594857600000",
"number": "1457969396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12752 EVERLASTING DR",
"city": "PARK RAPIDS",
"state": "MN",
"postal_code": "564703282",
"telephone_number": "218-252-9905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2405 8TH ST S STE 200",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565604200",
"telephone_number": "218-382-1267",
"fax_number": "218-331-4867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERHARDT",
"first_name": "PAULA",
"middle_name": "R",
"credential": "LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-16",
"last_updated": "2020-07-16",
"certification_date": "2020-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "305652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moorhead, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.