Individual provider Active NPI

Melissa Maria Baxter, CADC II

  • Addiction (Substance Use Disorder) Counselor
  • Clearlake, CA
National Provider Identifier
1043794449
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
A063290923 Issued in CA
Practice address
14715 East Highway 20
Clearlake, CA 95423
Phone
(707) 998-1800
NPI assigned
Sep 20, 2018
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Addiction (Substance Use Disorder) Counselor 101YA0400X R1331731218 CA
Addiction (Substance Use Disorder) Counselor 101YA0400X A063290923 CA Primary

Addresses

Primary practice location

14715 East Highway 20
Clearlake, CA 95423

Mailing address

PO Box 366
Clearlake Oaks, CA 95423-0366
Phone (707) 998-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A063290923CAMDAddiction (Substance Use Disorder) Counselor
R1331731218CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hilltop Recovery Services CurrentSince Jan 14, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1043794449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 366",
            "city": "CLEARLAKE OAKS",
            "state": "CA",
            "postal_code": "954230366",
            "telephone_number": "707-998-1800",
            "fax_number": "707-998-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14715 EAST HIGHWAY 20",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "95423",
            "telephone_number": "707-998-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAXTER",
        "first_name": "MELISSA",
        "middle_name": "MARIA",
        "credential": "CADC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1331731218",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A063290923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearlake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.