Individual provider Active NPI

Kasey L Wilson, ADC-T

  • Addiction (Substance Use Disorder) Counselor
  • Sandstone, MN
National Provider Identifier
1992426159
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
MNCD302809 Issued in MN
Practice address
413 Commercial Ave N
Sandstone, MN 55072-4412
Phone
(320) 245-9966
NPI assigned
Sep 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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 MNCD302809 MN Primary

Addresses

Primary practice location

413 Commercial Ave N
Sandstone, MN 55072-4412

Mailing address

PO Box 286
Sandstone, MN 55072-0286
Phone (320) 245-9966

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
MNCD302809MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ascertain Recovery Centre' LLC CurrentSince Sep 11, 2022 Accepting new patients
Ascertain Recovery Centre' LLC Addiction (Substance Use Disorder) CurrentSince Sep 11, 2022 Accepting new patients
Recovery Roots Supportive Services LLC Addiction (Substance Use Disorder) CurrentSince Aug 18, 2024 Accepting new patients

Locations

413 Commercial Ave N
Sandstone, MN 55072
Phone (320) 245-9966

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1992426159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 286",
            "city": "SANDSTONE",
            "state": "MN",
            "postal_code": "550720286",
            "telephone_number": "320-245-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 COMMERCIAL AVE N",
            "city": "SANDSTONE",
            "state": "MN",
            "postal_code": "550724412",
            "telephone_number": "320-245-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KASEY",
        "middle_name": "L",
        "credential": "ADC-T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "MNCD302809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandstone, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.