NPIMap

Organization Active NPI

The Scott County Jail Treatment Program

  • Addiction (Substance Use Disorder) Counselor
  • Shakopee, MN
National Provider Identifier
1609146364
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1062184 Issued in MN
Legal business name
THE SCOTT COUNTY JAIL TREATMENT PROGRAM
Practice address
301 Fuller St S
Shakopee, MN 55379-1322
Phone
(952) 447-1117
Fax
(952) 447-1116
NPI assigned
Jan 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Authorized official

Name
Mr. William Milo Walberg, BS, LADC
Title
Executive Director
Phone
(952) 447-1117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X 1062184 MN Primary

Addresses

Primary practice location

301 Fuller St S
Shakopee, MN 55379-1322

Mailing address

14162 Commerce Ave NE
Suite 400
Prior Lake, MN 55372-1480
Phone (952) 447-1117

Other names 1

  • Loren E. Novak & Associates Inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Journey Counseling Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

301 Fuller St S
Shakopee, MN 55379
Phone (952) 447-1117

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1609146364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14162 COMMERCE AVE NE",
            "address_2": "SUITE 400",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553721480",
            "telephone_number": "952-447-1117",
            "fax_number": "952-447-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 FULLER ST S",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791322",
            "telephone_number": "952-447-1117",
            "fax_number": "952-447-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SCOTT COUNTY JAIL TREATMENT PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "WALBERG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MILO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "952-447-1117",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS, LADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "1062184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loren E. Novak & Associates Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shakopee, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.