Individual provider Active NPI

Andres Antonio Escobar, MS, LCADC, CCS

  • Addiction (Substance Use Disorder) Counselor
  • Camden, NJ
National Provider Identifier
1194901892
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
400 Market St
Camden, NJ 08102-1526
Phone
(856) 541-1700
NPI assigned
Jan 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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 Primary

Addresses

Primary practice location

400 Market St
Camden, NJ 08102-1526

Mailing address

104 N King St
Gloucester City, NJ 08030-1417
Phone (856) 742-0900

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
My Father'S House, Inc Addiction (Substance Use Disorder) Current Accepting new patients
My Father'S House, Inc CurrentSince Oct 9, 2022 Accepting new patients

Locations

104 N King St
Gloucester City, NJ 08030
Phone (856) 742-0900

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1194901892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N KING ST",
            "city": "GLOUCESTER CITY",
            "state": "NJ",
            "postal_code": "080301417",
            "telephone_number": "856-742-0900",
            "fax_number": "856-742-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MARKET ST",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081021526",
            "telephone_number": "856-541-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCOBAR",
        "first_name": "ANDRES",
        "middle_name": "ANTONIO",
        "name_prefix": "Mr.",
        "credential": "MS, LCADC, CCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-14",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.