Individual provider Active NPI

Megan Jagiello-Wielczyk, CATC

  • Addiction (Substance Use Disorder) Counselor
  • San Marcos, CA
National Provider Identifier
1174033484
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1710106 Issued in CA
Practice address
1560 Capalina Rd
San Marcos, CA 92069-1288
Phone
(760) 744-2104
NPI assigned
Oct 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1710106 CA Primary

Addresses

Primary practice location

1560 Capalina Rd
San Marcos, CA 92069-1288

Mailing address

1560 Capalina Rd
San Marcos, CA 92069-1288
Phone (760) 744-2104

Other practice location 1

519 Avenida Blanco
San Marcos, CA 92069-1366
Phone (718) 702-5182

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
1710106CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1174033484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 CAPALINA RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920691288",
            "telephone_number": "760-744-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 CAPALINA RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920691288",
            "telephone_number": "760-744-2104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "519 Avenida Blanco",
            "address_purpose": "LOCATION",
            "city": "San Marcos",
            "state": "CA",
            "postal_code": "920691366",
            "country_code": "US",
            "telephone_number": "718-702-5182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAGIELLO-WIELCZYK",
        "first_name": "MEGAN",
        "credential": "CATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "1710106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.