Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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New Salem Metamorphosis Adolesent Program

Organization Addiction (Substance Use Disorder) Counselor · NPI 1750636973

New Salem Metamorphosis Adolesent Program is an Addiction (Substance Use Disorder) Counselor in Minneapolis, Minnesota. Licensed in Minnesota. Registered with an NPI since 2012.

Licensed in
MN
In the registry since
2012
Specialties on file
2
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Practice location Address checks out

2507 Bryant Ave N
Minneapolis, MN 55411-2116
Phone: (612) 250-8799
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 1061325-1-CDT (MN)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X

Record details

NPI number1750636973
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Hortense Jones — Program Administrator · (612) 250-8799
NPI enumeratedJuly 14, 2012
Last updated in NPPESJuly 14, 2012
Mailing address2507 Bryant Ave N, Minneapolis, MN 55411-2116

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