Active NPI
Janet M Edmonds, COUNSELOR CAS, RAS
- Addiction (Substance Use Disorder) Counselor
- Clearlake, CA
National Provider Identifier
1174968978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CAS 03-108316
- Practice address
- 7000B S Center Dr
Clearlake, CA 95422-8131 - Phone
- (707) 099-4709
- NPI assigned
- May 7, 2013
- 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 | CAS 03-108316 | CA | Primary |
Addresses
Primary practice location
7000B S Center Dr
Clearlake, CA 95422-8131
Mailing address
7000B S Center Dr
Clearlake, CA 95422-8131
Phone (707) 994-7090
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 |
|---|---|---|---|
| CAS 03-108316 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437955200000",
"number": "1174968978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7000B S CENTER DR",
"city": "CLEARLAKE",
"state": "CA",
"postal_code": "954228131",
"telephone_number": "707-994-7090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7000B S CENTER DR",
"city": "CLEARLAKE",
"state": "CA",
"postal_code": "954228131",
"telephone_number": "707-099-4709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMONDS",
"first_name": "JANET",
"middle_name": "M",
"credential": "COUNSELOR CAS, RAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-07",
"last_updated": "2015-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "CAS 03-108316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearlake, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.