Individual provider Active NPI

Rock Allen Todd, LAC, LASAC

  • Addiction (Substance Use Disorder) Counselor
  • Phoenix, AZ
National Provider Identifier
1205073582
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LASAC-13099 Issued in AZ
Practice address
8825 N 23Rd Ave
Suite#100
Phoenix, AZ 85021-4147
Phone
(602) 861-2255
Fax
(602) 861-2288
NPI assigned
Jan 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LASAC-13099 AZ Primary
Mental Health Counselor 101YM0800X LAC-12887 AZ

Addresses

Primary practice location

8825 N 23Rd Ave
Suite#100
Phoenix, AZ 85021-4147

Mailing address

1811 S Alma School Rd
Suite# 160
Mesa, AZ 85210-3001
Phone (480) 831-7566

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
LASAC-13099AZMDAddiction (Substance Use Disorder) Counselor
LAC-12887AZMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231372800000",
    "number": "1205073582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 S ALMA SCHOOL RD",
            "address_2": "SUITE# 160",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103001",
            "telephone_number": "480-831-7566",
            "fax_number": "480-962-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8825 N 23RD AVE",
            "address_2": "SUITE#100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850214147",
            "telephone_number": "602-861-2255",
            "fax_number": "602-861-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "ROCK",
        "middle_name": "ALLEN",
        "credential": "LAC, LASAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LASAC-13099",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-12887",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.