Individual provider Active NPI

Susan Holter, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Stillwater, MN
National Provider Identifier
1740754837
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
301610 Issued in MN
Practice address
1825 Curve Crest Blvd W Ste 103
Stillwater, MN 55082-6054
Phone
(612) 326-7584
Fax
(651) 351-0162
NPI assigned
Jan 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 301610 MN Primary

Addresses

Primary practice location

1825 Curve Crest Blvd W Ste 103
Stillwater, MN 55082-6054

Mailing address

1825 Curve Crest Blvd W Ste 103
Stillwater, MN 55082-6054
Phone (612) 326-7584

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

LicenseStateTypeSpecialty
301610MNMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1740754837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 CURVE CREST BLVD W STE 103",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826054",
            "telephone_number": "612-326-7584",
            "fax_number": "651-351-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 CURVE CREST BLVD W STE 103",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826054",
            "telephone_number": "612-326-7584",
            "fax_number": "651-351-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTER",
        "first_name": "SUSAN",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "301610",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 11, 2019; 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.