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WALLACE LARRY KLOSTREICH LAC
NPI 1073540415
Counselor - Addiction (Substance Use Disorder) in Bismarck, ND

Active since June 28, 2006
1237 W DIVIDE AVE, STE 5, BISMARCK, ND 58501(701) 328-8892(701) 328-8900 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wallace Larry Klostreich Lac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALLACE LARRY KLOSTREICH LAC (NPI 1073540415) is an individual addiction (substance use disorder) provider in Bismarck, North Dakota, licensed in North Dakota (1073) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1073540415
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameWALLACE LARRY KLOSTREICHCredential: LAC
Location Address1237 W DIVIDE AVE, STE 5Bismarck, ND 58501-1208
Mailing Address1237 W Divide Ave, Ste 5Bismarck, ND 58501-1208 · (701) 328-8892 · Fax (701) 328-8900
Phone(701) 328-8892
Fax(701) 328-8900
Sole ProprietorNo
Enumeration DateJune 28, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1073540415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in ND · 1073
1237 W DIVIDE AVE, Bismarck, ND 58501
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Other Identifiers 1

Other024576Bcbs Of Nd

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHAEL A TROM RN
Nurse Practitioner (Psychiatric/Mental Health)
1237 W DIVIDE AVE, STE 5
BISMARCK, ND 58501
Burleigh County (701) 328-8888
ADRIANNA GABRIELLE TINCHER
Registered Nurse
1237 W DIVIDE AVE
BISMARCK, ND 58501
Burleigh County (701) 328-8888
THOMAS CONMAY III CASE MANAGER
Case Manager/Care Coordinator
1237 W DIVIDE AVE
BISMARCK, ND 58501
Burleigh County (701) 328-8888
SUE A MOCK LAC
Counselor (Addiction (Substance Use Disorder))
1237 W DIVIDE AVE, STE 5
BISMARCK, ND 58501
Burleigh County (701) 328-8763
TARA MOSZER LAC
Counselor (Addiction (Substance Use Disorder))
1237 W DIVIDE AVE, STE 5
BISMARCK, ND 58501
Burleigh County (701) 328-8888
JACKIE MARIE LELM LICSW, MSW
Social Worker (Clinical)
1237 W DIVIDE AVE, STE 5
BISMARCK, ND 58501
Burleigh County (701) 328-8843
HELEN SAMUELSON RN, BC
Registered Nurse
1237 W DIVIDE AVE, STE 5
BISMARCK, ND 58501
Burleigh County (701) 328-8820
HOPE RUSH
Case Manager/Care Coordinator
1237 W DIVIDE AVE, STE 5
BISMARCK, ND 58501
Burleigh County (701) 328-8859

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wallace Klostreich's NPI number?

The NPI number for Wallace Klostreich is 1073540415. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Where is Wallace Klostreich located?

Wallace Klostreich practices at 1237 W Divide Ave Ste 5, Bismarck, ND 58501. The listed phone number is (701) 328-8892.

What is Wallace Klostreich's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Wallace Klostreich was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.