Individual provider · Type 1 NPI

Clayton Thaddeus Rudolf Phillips, LADC

Addiction (Substance Use Disorder) Counselor · St. Paul, MN

NPI number 1093650988 Active

Practice location

680 Stewart Ave
St. Paul, MN 55102-4117

Call (763) 957-7677 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X306742 (MN)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1093650988

Clayton Thaddeus Rudolf Phillips, LADC's National Provider Identifier is 1093650988, issued on Apr 20, 2026. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in St. Paul, MN. The record was last updated on Apr 20, 2026.