Individual provider Active NPI

Rita Joe, C.AD, LADAC, CACIII,

  • Addiction (Substance Use Disorder) Counselor
  • Shiprock, NM
National Provider Identifier
1053529636
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
3955 Issued in NM
Practice address
Pinon & Cottonwood Dr Building #2301
Shiprock, NM 87420
Phone
(505) 368-1438
Fax
(505) 368-1461
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1864 AZ
Addiction (Substance Use Disorder) Counselor 101YA0400X 17315 AZ
Addiction (Substance Use Disorder) Counselor 101YA0400X RRNN32 AZ
Addiction (Substance Use Disorder) Counselor 101YA0400X 3955 NM Primary

Addresses

Primary practice location

Pinon & Cottonwood Dr Building #2301
Shiprock, NM 87420

Mailing address

PO Box 273
Towaoc, CO 81334-0273
Phone (970) 560-2414

Other practice location 1

Dorm 2 Yucca St
Shiprock, NM 87420
Phone (505) 368-1465

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
17315AZMDAddiction (Substance Use Disorder) Counselor
RRNN32AZMDAddiction (Substance Use Disorder) Counselor
3955NMMDAddiction (Substance Use Disorder) Counselor
1864AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Navajo Regional Behavioral Health Center - Outpatient Addiction (Substance Use Disorder) CurrentSince Sep 25, 2019 Accepting new patients
Navajo Regional Behavioral Health Center - Adult Residential Treatment CurrentSince Oct 19, 2020 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1053529636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 273",
            "city": "TOWAOC",
            "state": "CO",
            "postal_code": "813340273",
            "telephone_number": "970-560-2414",
            "fax_number": "505-368-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PINON & COTTONWOOD DR BUILDING #2301",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "87420",
            "telephone_number": "505-368-1438",
            "fax_number": "505-368-1461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Dorm 2 Yucca St",
            "address_purpose": "LOCATION",
            "city": "Shiprock",
            "state": "NM",
            "postal_code": "87420",
            "country_code": "US",
            "telephone_number": "505-368-1465",
            "fax_number": "505-368-1467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOE",
        "first_name": "RITA",
        "credential": "C.AD, LADAC, CACIII,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "1864",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "17315",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "RRNN32",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "3955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiprock, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; 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.