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NICOLE SHANNON THULL SAC-IT
NPI 1669962825
Counselor - Addiction (Substance Use Disorder) in Kewaskum, WI

Active since May 14, 2018
1421 FOND DU LAC AVE, KEWASKUM, WI 53040(262) 626-4166(262) 626-8431 Get Directions Write a Review

NPPES record last updated: May 14, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nicole Shannon Thull Sac-it NPPES

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

NICOLE SHANNON THULL SAC-IT (NPI 1669962825) is an individual addiction (substance use disorder) provider in Kewaskum, Wisconsin, licensed in Wisconsin (17291-130) and active in the NPI registry since May 2018.

NPPES Registry Identity

NPI1669962825
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameNICOLE SHANNON THULLCredential: SAC-IT
Location Address1421 FOND DU LAC AVEKewaskum, WI 53040-9136
Mailing Address9349 Windy Acres DrKewaskum, WI 53040-9742 · (262) 483-4870
Phone(262) 626-4166
Fax(262) 626-8431
Sole ProprietorNo
Enumeration DateMay 14, 2018
✔ NPI 1669962825 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 · 17291-130
1421 FOND DU LAC AVE, Kewaskum, WI 53040
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Other Providers at the Same Location NPPES 3

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

AMBER ANN WEBB
Counselor (Addiction (Substance Use Disorder))
1421 FOND DU LAC AVE
KEWASKUM, WI 53040
Washington County (262) 626-4166
EXODUS TRANSITIONAL CARE FACILITY INC.
Substance Abuse Rehabilitation Facility
1421 FOND DU LAC AVE
KEWASKUM, WI 53040
Washington County (626) 626-4166
BRITNEY MAE O'BRIEN SACIT
Counselor (Addiction (Substance Use Disorder))
1421 FOND DU LAC AVE
KEWASKUM, WI 53040
Washington County (262) 626-4166

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 Nicole Thull's NPI number?

The NPI number for Nicole Thull is 1669962825. It was assigned to this individual provider in the NPPES registry on May 14, 2018.

Where is Nicole Thull located?

Nicole Thull practices at 1421 Fond Du Lac Ave, Kewaskum, WI 53040. The listed phone number is (262) 626-4166.

What is Nicole Thull'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 Nicole Thull was last updated on May 14, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.