Active NPI
Juan Iglesias, CASAC-T
- Addiction (Substance Use Disorder) Counselor
- Highland, NY
National Provider Identifier
1235312596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 21398
- Practice address
- 106 Vineyard Ave
Highland, NY 12528-1422 - Phone
- (845) 647-5400
- Fax
- (845) 647-5419
- NPI assigned
- Dec 10, 2007
- Sex
- Male
- 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 | 21398 | NY | Primary |
Addresses
Primary practice location
106 Vineyard Ave
Highland, NY 12528-1422
Mailing address
106 Vineyard Ave
Highland, NY 12528-1422
Phone (845) 647-5400
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 |
|---|---|---|---|
| 21398 | NY | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197244800000",
"number": "1235312596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 VINEYARD AVE",
"city": "HIGHLAND",
"state": "NY",
"postal_code": "125281422",
"telephone_number": "845-647-5400",
"fax_number": "845-647-5419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 VINEYARD AVE",
"city": "HIGHLAND",
"state": "NY",
"postal_code": "125281422",
"telephone_number": "845-647-5400",
"fax_number": "845-647-5419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IGLESIAS",
"first_name": "JUAN",
"name_prefix": "Mr.",
"credential": "CASAC-T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-10",
"last_updated": "2007-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "21398",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.