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TIMOTHY JAMES MODER SAC-IT
NPI 1437332319
Counselor - Addiction (Substance Use Disorder) in Superior, WI

Active since December 13, 2007
1507 TOWER AVE, # 307, SUPERIOR, WI 54880(715) 392-9300(715) 392-8041 Get Directions Write a Review

NPPES record last updated: December 13, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Timothy James Moder Sac-it NPPES

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

TIMOTHY JAMES MODER SAC-IT (NPI 1437332319) is an individual addiction (substance use disorder) provider in Superior, Wisconsin, licensed in Wisconsin (14242-130) and active in the NPI registry since December 2007.

NPPES Registry Identity

NPI1437332319
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameTIMOTHY JAMES MODERCredential: SAC-IT
Location Address1507 TOWER AVE, # 307Superior, WI 54880-2532
Mailing Address1115 Lincoln StSuperior, WI 54880-6730 · (218) 940-3518
Phone(715) 392-9300
Fax(715) 392-8041
Sole ProprietorNo
Enumeration DateDecember 13, 2007
✔ NPI 1437332319 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 WI · 14242-130
1507 TOWER AVE, Superior, WI 54880
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Other Providers at the Same Location NPPES 10

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

DR. ARTHUR DAVID ZEHM DDS
Dentist
1507 TOWER AVE, STE 409
SUPERIOR, WI 54880
Douglas County (715) 392-3499
TWIN PORTS DENTAL
Dentist (General Practice)
1507 TOWER AVE, ROOM 427
SUPERIOR, WI 54880
Douglas County (715) 394-5792
DR. BRENT T JOHNSON DDS
Dentist (General Practice)
1507 TOWER AVE, SUITE 202
SUPERIOR, WI 54880
Douglas County (715) 394-3683
RIDGEWOOD RECOVERY, INC.
Community/Behavioral Health
1507 TOWER AVE, SUITE 307
SUPERIOR, WI 54880
Douglas County (715) 392-9300
MR. EDWARD C WIPSON MS LPC CSAC
Counselor (Mental Health)
1507 TOWER AVE, SUITE 210
SUPERIOR, WI 54880
Douglas County (715) 392-3331
DR. RICHARD MATHIAS JOHNSON DDS
Dentist
1507 TOWER AVE, RM 427
SUPERIOR, WI 54880
Douglas County (715) 394-5792
MISS ALISHA MARIE BLISS CSAC, LADC
Counselor (Addiction (Substance Use Disorder))
1507 TOWER AVE, SUITE 307
SUPERIOR, WI 54880
Douglas County (715) 392-9300
DR. RONALD KEITH UNDERDALE DDS
Dentist
1507 TOWER AVE, SUITE 211
SUPERIOR, WI 54880
Douglas County (715) 394-9450

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 Timothy Moder's NPI number?

The NPI number for Timothy Moder is 1437332319. It was assigned to this individual provider in the NPPES registry on December 13, 2007.

Where is Timothy Moder located?

Timothy Moder practices at 1507 Tower Ave # 307, Superior, WI 54880. The listed phone number is (715) 392-9300.

What is Timothy Moder'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 Timothy Moder was last updated on December 13, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.