GREGORY JOHN ROBERTSON LADC NPI 1881230134

NPI Information

NPI: 1881230134
Provider Name: GREGORY JOHN ROBERTSON, LADC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
1380 ENERGY LN STE 203
SAINT PAUL, MN
ZIP 55108
Phone: (651) 210-5287
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Gregory John Robertson, LADC is an addiction (substance use disorder) counselor in Saint Paul, MN. Gregory John Robertson, LADC NPI is 1881230134. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1380 ENERGY LN STE 203
SAINT PAUL, MN
ZIP 55108-253
Phone: (651) 210-5287
Fax: (651) 212-4884

The enumeration date for this NPI number is 11/21/2019 and was last updated on 11/21/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	300291	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	13465318094	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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