Jacob Edward Struhelka, CLINICAL SUBSTANCE A

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

15257132 Issued in WI

Practice address

3301 N Ballard Rd Ste B
Appleton, WI 54911-9002

Phone

(920) 733-4443

Fax

(920) 733-4796

NPI assigned

May 10, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1881808533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 N BALLARD RD STE B",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549119002",
            "telephone_number": "920-733-4443",
            "fax_number": "920-733-4796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 N BALLARD RD STE B",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549119002",
            "telephone_number": "920-733-4443",
            "fax_number": "920-733-4796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRUHELKA",
        "first_name": "JACOB",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "CLINICAL SUBSTANCE A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15257132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42018000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Strive Therapy and Wellness LLC
• Benjamin Louis Strobel, DDS
• Heather Strobl, RN
• Darren Collin Strong, D.C.
• Derek C Strong, D.C.
• Ashley M Strunk, LPC
• Julie A Strutz, OTR, CHT
• Melissa R Stuczynski, LPN
• Heather Anne Stumpf, R.D.
• Crystal J Sturgis, PA C

• Addiction (Substance Use Disorder) Counselor in Appleton, WI
• Providers in Appleton, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.