Active NPI
Trenton Estano, SAC-IT
- Addiction (Substance Use Disorder) Counselor
- Green Bay, WI
National Provider Identifier
1689187494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 18333-130
- Practice address
- 424 S Monroe Ave Ste 201
Green Bay, WI 54301-4054 - Phone
- (920) 445-0170
- Fax
- (920) 445-0174
- NPI assigned
- Nov 15, 2017
- Sex
- Male
- 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 | 18333-130 | WI | Primary |
Addresses
Primary practice location
424 S Monroe Ave Ste 201
Green Bay, WI 54301-4054
Mailing address
424 S Monroe Ave Ste 201
Green Bay, WI 54301-4054
Phone (920) 445-0170
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 |
|---|---|---|---|
| 18333-130 | WI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510704000000",
"number": "1689187494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 S MONROE AVE STE 201",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543014054",
"telephone_number": "920-445-0170",
"fax_number": "920-445-0174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 S MONROE AVE STE 201",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543014054",
"telephone_number": "920-445-0170",
"fax_number": "920-445-0174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTANO",
"first_name": "TRENTON",
"credential": "SAC-IT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-15",
"last_updated": "2017-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "18333-130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.