Active NPI
Stephanie Oreen Gilquist, LADC
- Addiction (Substance Use Disorder) Counselor
- Stillwater, MN
National Provider Identifier
1659664209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 301918
- Practice address
- 11400 Julianne Ave N
Stillwater, MN 55082-9436 - Phone
- (651) 426-3300
- Fax
- (651) 426-0419
- NPI assigned
- May 16, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 301918 | MN | Primary |
Addresses
Primary practice location
11400 Julianne Ave N
Stillwater, MN 55082-9436
Mailing address
11400 Julianne Ave N
Stillwater, MN 55082-9436
Phone (651) 426-3300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 301918 | Other | MN | BOARD OF BEHAVIORAL HEALTH AND THERAPY |
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 |
|---|---|---|---|
| 301918 | 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": "1305504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305504000000",
"number": "1659664209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11400 JULIANNE AVE N",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550829436",
"telephone_number": "651-426-3300",
"fax_number": "651-426-0419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11400 JULIANNE AVE N",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550829436",
"telephone_number": "651-426-3300",
"fax_number": "651-426-0419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILQUIST",
"first_name": "STEPHANIE",
"middle_name": "OREEN",
"credential": "LADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-16",
"last_updated": "2011-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "301918",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF BEHAVIORAL HEALTH AND THERAPY",
"identifier": "301918",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.