Provider Demographics
NPI:1215178504
Name:WAHUS, DONALD DEAN (LAC, NCACII, SAP)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:DEAN
Last Name:WAHUS
Suffix:
Gender:M
Credentials:LAC, NCACII, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 6TH ST W
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-4810
Mailing Address - Country:US
Mailing Address - Phone:701-770-2649
Mailing Address - Fax:
Practice Address - Street 1:901 6TH ST W
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-4810
Practice Address - Country:US
Practice Address - Phone:701-770-2649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1131101YA0400X
MT899101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)