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NPI Code Detail

MEDICARE: PETER ADAM TRUELL LCPC

MEDICARE: PETER ADAM TRUELL LCPC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor17477-130WI
2101YP2500XProfessional Counselor180.011893IL
3101YP2500XProfessional Counselor2618-226WI

General Provider Information

NPI Number : 1639628241
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER ADAM TRUELL LCPC
Provider Business Mailing Address
First Line : W175 N1110 STONEWOOD DR
Second Line :
City : GERMANTOWN
State : WI
Zip : 53022-6511
Country : US
Telephone Number : 800-438-1772
Fax Number : 262-293-9737
Provider Business Practice Location Address
First Line : 175 E HAWTHORN PKWY STE 235
Second Line :
City : VERNON HILLS
State : IL
Zip : 60061-1454
Country : US
Telephone Number : 888-428-7890
Fax Number : 877-428-7891
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2016
Last Update Date : 06/16/2026

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