MR. ANDREW SUDBECK (NPI# 1164798948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164798948 |
| Entity Type | Individual |
| Full Name | MR. ANDREW SUDBECK |
| Credential | BS, LADC |
| Practice Address |
101 18th Avenue North Princeton MN 55371 |
| Mailing Address |
1506 1st Street Princeton MN 55371 |
| Practice Telephone | 7633895080 |
| Practice Fax Number | 7636319117 |
| Mailing Telephone | 7633895080 |
| Mailing Fax Number | 7636319117 |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2012-03-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
302611 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | LADC | 302611 | 01 |
| Street Address |
101 18TH AVENUE NORTH |
| City | PRINCETON |
| State | MN |
| Zip Code | 55371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053962530 | Monica Gail Broten | Technician | 30840 Tiger Street Nw, Princeton, MN 55371 | 2019-09-25 |
| 1215349584 | Stephen Destefano | Pharmacist | 31419 131st Street, Princeton, MN 55371 | 2014-05-21 |
| 1073804803 | Sterling Pointe Senior Living LLC | Assisted Living Facility | 1250 Northland Drive, Princeton, MN 55371 | 2011-04-27 |
| 1568752533 | Rum River Health Services, Inc. | Substance Abuse Rehabilitation Facility | 3079 90th Avenue, Princeton, MN 55371 | 2011-04-12 |
| 1780989038 | Dr. Kynan Westermeyer, Dds, Pllc | Clinic/Center | 404 1st St. N, Princeton, MN 55371 | 2011-01-18 |
| 1275788085 | Cody James Leff | Pharmacist | 1100 11th Avenue South, Princeton, MN 55371 | 2008-11-20 |
| 1164679213 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1101 N 5th St, Princeton, MN 55371 | 2008-08-20 |
| 1801059639 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1506 1st Street, Princeton, MN 55371 | 2008-07-02 |
| 1497940928 | James Michael Mandt | Pharmacist | 911 Northland Drive, Fairview Northland Medical Center, Princeton, MN 55371 | 2007-09-07 |
| 1225194475 | Thomas L Nunnelee Inc | Eyewear Supplier (Equipment, not the service) | 900 Rum River Dr South, Suite 103, Princeton, MN 55371 | 2006-12-29 |
| Find all providers in zip 55371 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811595564 | John Harlan Daniels | Counselor | 1982 Woodard Rd, Princeton, NC 27569-8315 | 2020-10-14 |
| 1366913204 | Misty Amber Cadle | Counselor | 108 Morrison Dr, Princeton, WV 24740-2322 | 2018-12-17 |
| 1477055812 | Ruth Ann Homer | Counselor | 10 Forrestal Rd S Ste 203, Princeton, NJ 08540-6666 | 2018-03-01 |
| 1043572647 | Ana Guerra | Counselor | 812 State Rd Ste 206, Princeton, NJ 08540-1400 | 2012-06-11 |
| 1275801144 | Mary Ann Godefroy | Counselor | 17 Chestnut Street, Princeton, NJ 08542 | 2011-12-07 |
| 1639458607 | Pierina Thayer | Counselor | 40 Witherspoon Street, Princeton, NJ 08542 | 2011-08-09 |
| 1912212762 | Anna Murawska | Counselor | 145 Witherspoon Str, Suite A4, Princeton, NJ 08542-3228 | 2010-08-17 |
| 1740500255 | Jessica N Caraballo | Counselor | 401 Peter Dana Point Rd, Princeton, ME 04668 | 2010-06-07 |
| 1326275280 | Lucy Harman | Counselor | 106 Broadmead St, Princeton, NJ 08540-7216 | 2009-06-18 |
| 1821263401 | Mark Thomas Fischer | Counselor | 808 7th Ave N Apt 4, Princeton, MN 55371-1241 | 2008-04-24 |
| Find all providers in PRINCETON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.