Reginald C Christiansen, CADCIII LADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Ellsworth, WI
NPI 1992878441 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1992878441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 812 (WI)
- Practice address
- 412 W Kinne St
Ellsworth, WI 54011 - Phone
- (715) 273-6770
- Fax
- (715) 273-6770
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 301067 | MN | MD | Addiction (Substance Use Disorder) Counselor |
| 812 | WI | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 812 | WI | Yes |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 301067 | MN |
Addresses
Primary practice location
412 W Kinne St
Ellsworth, WI 54011
Mailing address
PO Box 670
Ellsworth, WI 54011-0670
Phone (715) 273-6770
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39345400 | Medicaid | WI | |
| 5H765CH | Other | MN | BLUECROSS BLUESHIELD |
| 920461021641 | Other | MN | PREFERRED ONE |
Other providers in Ellsworth, WI
- Kimberly A Bowen
- Cheryl Ann Marcon Braun
- Brittney Brenner
- Kayla Marie Buck
- CB Therapy Group, LLC
- County of Pierce
- County of Pierce
- County of Pierce
- County of Pierce
- Kyle J Cress
All providers in Ellsworth, WI · Addiction (Substance Use Disorder) Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.