Individual provider Active NPI

Terry Sylvester Mader, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Alexandria, MN
National Provider Identifier
1912158338
Registry record updated Oct 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
301762 Issued in MN
Practice address
222 9TH Ave W
Alexandria, MN 56308-2221
Phone
(320) 763-3912
Fax
(320) 763-6629
NPI assigned
Oct 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 301762 MN Primary

Addresses

Primary practice location

222 9TH Ave W
Alexandria, MN 56308-2221

Mailing address

222 9TH Ave W
Alexandria, MN 56308-2221
Phone (320) 763-3912

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

LicenseStateTypeSpecialty
301762MNMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222992000000",
    "number": "1912158338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 9TH AVE W",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082221",
            "telephone_number": "320-763-3912",
            "fax_number": "320-763-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 9TH AVE W",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082221",
            "telephone_number": "320-763-3912",
            "fax_number": "320-763-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADER",
        "first_name": "TERRY",
        "middle_name": "SYLVESTER",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-03",
        "last_updated": "2008-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "301762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; 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.