| Jay Philip Wistrom, LADC | |
|
1321 13th St N, Saint Cloud, MN 56303-2613 | |
| (320) 252-5010 | |
| (320) 203-1855 |
| Full Name | Jay Philip Wistrom |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1321 13th St N, Saint Cloud, Minnesota |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144587452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 303309 (Minnesota) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jay Philip Wistrom, LADC 1321 13th St N, Saint Cloud, MN 56303-2613 Ph: (320) 252-5010 | Jay Philip Wistrom, LADC 1321 13th St N, Saint Cloud, MN 56303-2613 Ph: (320) 252-5010 |
Emmanuel Oppong, Counselor Medicare: Medicare Enrolled Practice Location: 22 Wilson Ave Ne Ste 209, Saint Cloud, MN 56304 Phone: 320-237-6996 | |
Billy M Anderson, LICSW LADC Counselor Medicare: Medicare Enrolled Practice Location: 22 Wilson Ave Ne, 209, Saint Cloud, MN 56304 Phone: 320-259-7706 Fax: 320-251-4590 | |
Benedict A Walz, MS MDV MAC LADC LMFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3333 W Division St, Midtown Square Suite # 210, Saint Cloud, MN 56301 Phone: 320-252-5781 Fax: 320-252-5001 | |
Tonya Sharon Klug, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1321 13th St N, Saint Cloud, MN 56303 Phone: 320-252-5010 Fax: 320-203-1855 | |
Hamdi Mahat Sirat, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2719 W Division St Ste 5, Saint Cloud, MN 56301 Phone: 952-212-0358 | |
Nasro Aden, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2719 W Division St Ste 5, Saint Cloud, MN 56301 Phone: 612-707-7530 | |
Laylo Salad Guled, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2719 W Division St Ste 5, Saint Cloud, MN 56301 Phone: 952-212-0358 |