Andrea Aikens
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Kenosha, WI
NPI 1760914865 · NPPES record last updated Mar 29, 2017
Key facts
- NPI
- 1760914865
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 17585-130 (WI)
- Practice address
- 2108 63Rd St
Kenosha, WI 53143-4454 - Phone
- (262) 652-2406
- Fax
- (262) 652-2408
- NPI assigned
- Mar 29, 2017
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 17585-130 | WI | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 17585-130 | WI | Yes |
Addresses
Primary practice location
2108 63Rd St
Kenosha, WI 53143-4454
Mailing address
2108 63Rd St
Kenosha, WI 53143-4454
Phone (262) 652-2406
Other providers in Kenosha, WI
- Dyson J Ahola
- Eric M. Ahonen
- Ahp 006 LLC
- Nancy Aiello
- William Aiello
- Stacey M Aker
- Akza LLC
- Alan a. Hyman, MD
- Jennifer Beth Albert
- Michael Anthony Albert
All providers in Kenosha, WI · Addiction (Substance Use Disorder) Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.