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

Organization Addiction (Substance Use Disorder) Counselor · NPI 1720354004

New Salem Metormorphosis Youth 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

2509 Bryant Ave N
Minneapolis, MN 55411
Phone: (612) 250-8799
Fax: (612) 529-9416
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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
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 301674 (MN)

Record details

NPI number1720354004
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Hortenese Jones — Program Administrator · (612) 250-8799
Other names New Salem Metormorphosis Youth Program
NPI enumeratedMarch 30, 2012
Last updated in NPPESMarch 30, 2012
Mailing address2507 Bryant Ave N, Minneapolis, MN 55411-2116

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