Ronaele M Clasen, SAC-IT

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Gresham, WI

NPI 1497462360 · NPPES record last updated Nov 1, 2022

Key facts

NPI
1497462360
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
19736-130 (WI)
Practice address
N2150 Kesaehkahtek
Gresham, WI 54128-2150
Phone
(715) 799-3835
Fax
(715) 799-5056
NPI assigned
Nov 1, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
19736-130WIMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 19736-130 WI Yes

Addresses

Primary practice location

N2150 Kesaehkahtek
Gresham, WI 54128-2150

Mailing address

N2150 Kesaehkahtek
Gresham, WI 54128-2150
Phone (715) 799-3835

Other providers in Gresham, WI

All providers in Gresham, WI · Addiction (Substance Use Disorder) Counselor in Wisconsin

Sources for this page

Verify at the official NPI Registry.