Gina Lee Adamski, LADC, CSAC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Superior, WI

NPI 1770837882 · NPPES record last updated Oct 29, 2012

Key facts

NPI
1770837882
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
302972 (MN)
Practice address
1507 Tower Ave Ste 307
Superior, WI 54880-2553
Phone
(218) 336-9300
Fax
(715) 392-8041
NPI assigned
Oct 29, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
302972MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgewood Recovery, Inc. Past Accepting new patients
Superior Treatment Center, Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 302972 MN Yes

Addresses

Primary practice location

1507 Tower Ave Ste 307
Superior, WI 54880-2553

Mailing address

1507 Tower Ave Ste 307
Superior, WI 54880-2553
Phone (218) 336-9300

Other identifiers

IdentifierTypeStateIssuer
302972OtherMNLADC

Other providers in Superior, WI

All providers in Superior, WI · Addiction (Substance Use Disorder) Counselor in Wisconsin

Sources for this page

Verify at the official NPI Registry.