John Francis Gorman

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Princeton, MN

NPI 1831449933 · NPPES record last updated Sep 16, 2012

Key facts

NPI
1831449933
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
301764 (MN)
Practice address
1506 1St St
Princeton, MN 55371-1462
Phone
(763) 389-5080
Fax
(763) 389-5453
NPI assigned
Sep 16, 2012
Sex
Male
Sole proprietor
Yes

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
301764MNMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 301764 MN Yes

Addresses

Primary practice location

1506 1St St
Princeton, MN 55371-1462

Mailing address

210 15TH Ave N
Apartment 205
Waite Park, MN 56387-1197
Phone (952) 201-6490

Other providers in Princeton, MN

All providers in Princeton, MN · Addiction (Substance Use Disorder) Counselor in Minnesota

Sources for this page

Verify at the official NPI Registry.