Carolann Ardis, RAS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

RASIRI-D0509150826 Issued in CA

Practice address

1001 Broadway
Suite 201
Jackson, CA 95642

Phone

(209) 223-6412

Fax

(209) 223-0920

NPI assigned

May 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053532127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BROADWAY",
            "address_2": "SUITE 201",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "95642",
            "telephone_number": "209-223-6412",
            "fax_number": "209-223-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BROADWAY",
            "address_2": "SUITE 201",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "95642",
            "telephone_number": "209-223-6412",
            "fax_number": "209-223-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDIS",
        "first_name": "CAROLANN",
        "credential": "RAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RASIRI-D0509150826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADDICTION SPECIALIST",
            "identifier": "RASIRI-D0509150826",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Jackson, CA
• Providers in Jackson, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.