Provider Demographics
NPI:1477214971
Name:VOLLBERG, KARLA A (CADC-DP)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:A
Last Name:VOLLBERG
Suffix:
Gender:F
Credentials:CADC-DP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 ROCK ST
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-4725
Mailing Address - Country:US
Mailing Address - Phone:906-227-9176
Mailing Address - Fax:906-228-2469
Practice Address - Street 1:1100 LUDINGTON ST STE 401
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-3545
Practice Address - Country:US
Practice Address - Phone:906-786-7212
Practice Address - Fax:906-786-0676
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIV416461067162OtherSUD SERVICES