1. Home
  2. Directory
  3. Wisconsin
  4. La Crosse
  5. Counselor
  6. NPI Profile

JERRY W SAMPLE CADC
NPI 1508806001
Counselor - Addiction (Substance Use Disorder) in La Crosse, WI

Active since June 07, 2006
1910 SOUTH AVE, LA CROSSE, WI 54601(608) 782-7300 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jerry W Sample Cadc NPPES

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

JERRY W SAMPLE CADC (NPI 1508806001) is an individual addiction (substance use disorder) provider in La Crosse, Wisconsin, licensed in Wisconsin (11750) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1508806001
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameJERRY W SAMPLECredential: CADC
Location Address1910 SOUTH AVELa Crosse, WI 54601-5467
Mailing Address1910 South AveLa Crosse, WI 54601-5467 · (608) 782-7300
Phone(608) 782-7300
Sole ProprietorNo
Enumeration DateJune 7, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1508806001 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 · 11750
1910 SOUTH AVE, La Crosse, WI 54601
Open in Google Maps ↗

Other Identifiers 1

Medicaid39393100WI

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.

MARK L TAYLOR CADC
Counselor (Addiction (Substance Use Disorder))
1910 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 775-2287
MR. CASEY JOHN BABLITCH B.S., CSAC
Counselor (Addiction (Substance Use Disorder))
1910 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 782-7300
MRS. KATELYN ELIZABETH CROTTEAU NP
Nurse Practitioner (Family)
1910 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 782-7300
KEVIN A ROSSITER M.D.
Internal Medicine (Nephrology)
1910 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 782-7300
JOSEPH BODNAR MS
Counselor (Professional)
1910 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 782-7300
MEGAN REBEKAH PINTER PHARMD
Pharmacist
1910 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 775-1126
SARAH S KEYESKI MA
Counselor (Professional)
1910 SOUTH AVE, LA CROSSE
LA CROSSE, WI 54601
La Crosse County (608) 775-2287
JACQUELYN M TOCK LPC
Counselor (Professional)
1910 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 782-7300

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 Jerry Sample's NPI number?

The NPI number for Jerry Sample is 1508806001. It was assigned to this individual provider in the NPPES registry on June 7, 2006.

Where is Jerry Sample located?

Jerry Sample practices at 1910 South Ave, La Crosse, WI 54601. The listed phone number is (608) 782-7300.

What is Jerry Sample'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 Jerry Sample 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.