Active NPI
Carolyn Lorraine Staples, LAC
- Addiction (Substance Use Disorder) Counselor
- Havre, MT
National Provider Identifier
1083960140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1079
- Practice address
- 521 4TH St
Havre, MT 59501-3649 - Phone
- (406) 395-4305
- Fax
- (406) 395-5997
- NPI assigned
- Jul 26, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1079 | MT | Primary |
Addresses
Primary practice location
521 4TH St
Havre, MT 59501-3649
Mailing address
1785 County Road 639 W
Havre, MT 59501-5101
Phone (406) 945-0426
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1079 | MT | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478131200000",
"number": "1083960140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1785 COUNTY ROAD 639 W",
"city": "HAVRE",
"state": "MT",
"postal_code": "595015101",
"telephone_number": "406-945-0426",
"fax_number": "406-395-5643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "521 4TH ST",
"city": "HAVRE",
"state": "MT",
"postal_code": "595013649",
"telephone_number": "406-395-4305",
"fax_number": "406-395-5997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAPLES",
"first_name": "CAROLYN",
"middle_name": "LORRAINE",
"name_prefix": "Mrs.",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-26",
"last_updated": "2016-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MT",
"license": "1079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Havre, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.