MEDICARE: MR. STEVEN ANTHONY ATTRIDGE BS, LADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	306246	MN

General Provider Information

NPI Number	:	1487455218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN ANTHONY ATTRIDGE BS, LADC

Provider Business Mailing Address
First Line	:	371 OLD HIGHWAY 8 SW APT 104
Second Line	:
City	:	NEW BRIGHTON
State	:	MN
Zip	:	55112-7728
Country	:	US
Telephone Number	:	763-222-9900
Fax Number	:

Provider Business Practice Location Address
First Line	:	371 OLD HIGHWAY 8 SW APT 104
Second Line	:
City	:	NEW BRIGHTON
State	:	MN
Zip	:	55112-7728
Country	:	US
Telephone Number	:	763-222-9900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2025
Last Update Date	:	06/11/2025

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