Active NPI
Garry Michael Walden, LADC
- Addiction (Substance Use Disorder) Counselor
- Hastings, MN
National Provider Identifier
1861220121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 307023
- Practice address
- 2961 Riverwood Dr
Hastings, MN 55033-3465 - Phone
- (651) 346-8719
- NPI assigned
- Jul 26, 2024
- Last updated
- Jul 26, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 307023 | MN | Primary |
Addresses
Primary practice location
2961 Riverwood Dr
Hastings, MN 55033-3465
Mailing address
2961 Riverwood Dr
Hastings, MN 55033-3465
Phone (651) 346-8719
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
| License | State | Type | Specialty |
|---|---|---|---|
| 307023 | MN | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721952000000",
"number": "1861220121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2961 RIVERWOOD DR",
"city": "HASTINGS",
"state": "MN",
"postal_code": "550333465",
"telephone_number": "651-346-8719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2961 RIVERWOOD DR",
"city": "HASTINGS",
"state": "MN",
"postal_code": "550333465",
"telephone_number": "651-346-8719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDEN",
"first_name": "GARRY",
"middle_name": "MICHAEL",
"credential": "LADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-26",
"last_updated": "2024-07-26",
"certification_date": "2024-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "307023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hastings, MN
- Vermillion Street Chiropractic LLC
- Beth Ellen Vongemmingen, LPCC, LADC
- Lynn Marie Wachtler, CNP
- Susan M Wagner, PT, CHT
- Wal-Mart Stores, Inc. (Vision Center 30-1472)
- Walgreen Co (Walgreens #05048)
- Laraine F Walker, PHD, LP
- Walmart Inc. (Walmart Pharmacy 10-1472)
- Anthony J Walsh, MD
- Viola Myntti Watroba, BSN, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.