Charles Tyler Upton, LISAC, PLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LISAC10856 Issued in AZ

Practice address

721 N. Fourth Ave
Tucson, AZ 85705

Phone

(520) 202-1870

Fax

(520) 202-1889

NPI assigned

Oct 19, 2010

Last updated

Oct 19, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Codac Behavioral Health Services of Pima County, Inc.

  • Adult Mental Health Clinic/Center
  • Tucson, AZ
  • NPI 1033319751
  NPD (past)
• Codac Health Recovery and Wellness

  dba CODAC at Speedway

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1649911157
  NPD (past)

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1104136571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 E. FORT LOWELL RD",
            "address_2": "STE 202",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857192378",
            "telephone_number": "520-327-4505",
            "fax_number": "520-202-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 N. FOURTH AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85705",
            "telephone_number": "520-202-1870",
            "fax_number": "520-202-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPTON",
        "first_name": "CHARLES",
        "middle_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "LISAC, PLC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC10856",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC11260",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Michael Untch, M.D.
• Prerana Upadhya, MD
• Upeendo Living LLC (San Pedro Oasis)
• Joseph Edward Upson, M.D.
• Sarah Marie Upson, MD
• Kiel Urata, M.D.
• Urban Wellness Center
• Amanda Urban-Tovar, PHARMD
• Diego Jesus Alejandro Urbina, MD
• Emily Urbina

• Addiction (Substance Use Disorder) Counselor in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Addiction (Substance Use Disorder) Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.