EDWARD KEHRWALD PHD, LAC
Addiction Substance Use Disorder
Bismarck, North Dakota
Provider NPI: 1780627489
Provider Information:EDWARD KEHRWALD PHD, LAC
Gender: M
Not Sole Proprietor
Practice Location:
1237 W DIVIDE AVE STE 5 BISMARCK, ND 58501 US
Tel: 701-328-8844 Fax: 701-328-8900
Business Mailing Address:
1237 W DIVIDE AVE STE 5 BISMARCK, ND 58501 US
Tel: 701-328-8844 Fax: 701-328-8900
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
X | 101YA0400X | Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder) | ND | 1324 |
X | 103TC0700X | Behavioral Health & Social Service Providers Psychologist | ND | 185 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
RR MEDICARE | P00323097 | 01 | |
BCBS OF ND PIN | 05274 | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin