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John Henry Adams Sr., SAC-IT

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

NPI 1780428383 · NPPES record last updated Jul 17, 2024

Key facts

NPI
1780428383
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
19544-130 (WI)
Practice address
2901 International LN Ste 100
Madison, WI 53704-3177
Phone
(608) 707-2272
Fax
(608) 480-8070
NPI assigned
Jun 20, 2024
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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
19544-130WIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Catalyst for Change Inc Current
since Jul 21, 2024		 Accepting new patients

Locations

2901 International Ln
Ste 100
Madison, WI 53704
Phone (608) 217-3798

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 19544-130 WI Yes

Addresses

Primary practice location

2901 International LN Ste 100
Madison, WI 53704-3177

Mailing address

2901 International LN Ste 100
Madison, WI 53704-3177
Phone (608) 707-2272

Other providers in Madison, WI

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

Sources for this page

Verify at the official NPI Registry.