Active NPI
Justin Dean Wahl Adame, SAC-IT
- Addiction (Substance Use Disorder) Counselor
- Sheboygan, WI
National Provider Identifier
1871387878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 20789-130
- Practice address
- 2801 Calumet Drive
Sheboygan, WI 53083 - Phone
- (951) 218-0403
- NPI assigned
- Apr 7, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 | 20789-130 | WI | Primary |
Addresses
Primary practice location
2801 Calumet Drive
Sheboygan, WI 53083
Mailing address
1100 S Irish Rd Apt 7
Chilton, WI 53014-1273
Phone (951) 218-0403
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 |
|---|---|---|---|
| 20789-130 | WI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743984000000",
"number": "1871387878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 S IRISH RD APT 7",
"city": "CHILTON",
"state": "WI",
"postal_code": "530141273",
"telephone_number": "951-218-0403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 CALUMET DRIVE",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "53083",
"telephone_number": "951-218-0403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAHL ADAME",
"first_name": "JUSTIN",
"middle_name": "DEAN",
"credential": "SAC-IT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-04-07",
"last_updated": "2025-04-07",
"certification_date": "2025-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "20789-130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sheboygan, WI
- Jessica Ann Wagner, OTR/L
- Jodi Lynn Wagner, OTR
- Lindsay Nicole Wagner, RN
- William G Wagner, MD
- Jeremy M Wagnon, D.C.
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- Wal-Mart Stores East LP (Walmart Pharmacy 10-3324)
- Amanda M Walesh, COTA, CLT
- Walgreen Co (Walgreens #12020)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.