MR. ANDREW SUDBECK


Address: 101 18th Avenue North, Princeton, MN 55371
Phone: 7633895080

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
MN LADC 302611 01

Office Location

Street Address 101 18TH AVENUE NORTH
City PRINCETON
State MN
Zip Code 55371

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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Competitor

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City PRINCETON
Zip Code 55371

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Dataset Information

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.

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