Michael John Mader, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

305816 Issued in MN

Practice address

375 Orleans St E
Stillwater, MN 55082-5830

Phone

(612) 368-5713

NPI assigned

Oct 6, 2020

Last updated

Oct 6, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 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": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1972100675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ORLEANS ST E",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825830",
            "telephone_number": "612-368-5713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 ORLEANS ST E",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825830",
            "telephone_number": "612-368-5713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADER",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-06",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305816",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.canvashealth.org/",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "375 Orleans St E",
            "city": "Stillwater",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550825830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan Helen Lundquist, BCTMB
• Jeffrey Thomas Lynch, M.D.
• Carla M Lynn, COTA
• Joseph Michael Macdonald, MD
• Kelsey Mackereth, COTA
• Joseph Callaghan Madigan, M.D.
• Sandra Magistad
• Jacqueline Marie Maiers, MS, CF-SLP
• Patricia Ann Makowski, MS, CRNA
• Ashton Mae Makwana, PA-C

• Addiction (Substance Use Disorder) Counselor in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; 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.