SHIRLEY CHRISTINE ZUPETZ LADC
Complete NPI Record 1306475983
Counselor - Addiction (Substance Use Disorder) in Saint Paul, MN

NPI Status: Active since April 06, 2020

Contact Information

1137 GRAND AVE
SAINT PAUL, MN
ZIP 55105
Phone: (612) 257-2391

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Complete NPI Dataset

This page represents the complete record for NPI 1306475983. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1306475983
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: SHIRLEY
The first name of the provider, if the provider is an individual.
Provider Middle Name: CHRISTINE
The middle name of the provider, if the provider is an individual.
Provider Credential Text: LADC
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Other Last Name: MITCHELL
Other last name by which the provider being identified is or has been known.
Provider Other First Name: SHIRLEY
Other first name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider first name’’ if the provider is or has been known by a different last name only.
Provider Other Middle Name: CHRISTINE
Other middle name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider middle name’’ if the provider is or has been known by a different last name only.
Provider Other Last Name Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider First Line Business Mailing Address: 1137 GRAND AVE
The last name of the provider. If the provider is an individual, this is the legal name.
Provider Business Mailing Address City Name: SAINT PAUL
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: MN
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 55105
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 6122572391
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 1137 GRAND AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: SAINT PAUL
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: MN
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 55105
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 6122572391
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 4/6/2020
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 4/6/2020
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 101YA0400X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 305471
The telephone number associated with the location address of the provider being identified.
Provider License Number State Code 1: MN
The date the provider was assigned a unique identifier (assigned an NPI).
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 305471
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: MN
Other Provider Identifier Issuer 1: LADC LICENSE NUMBER
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
NPI Certification Date: 4/6/2020