Roger Beckett, RADT
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Venice, CA
NPI 1265199764 · NPPES record last updated Jul 4, 2022
Key facts
- NPI
- 1265199764
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- R143640521 (CA)
- Practice address
- 503 Ocean Front Walk
Venice, CA 90291-2403 - Phone
- (310) 392-3070
- NPI assigned
- Nov 19, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R143640521 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoenix Houses of Los Angeles, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R143640521 | CA | Yes |
Addresses
Primary practice location
503 Ocean Front Walk
Venice, CA 90291-2403
Mailing address
503 Ocean Front Walk
Venice, CA 90291-2403
Phone (310) 392-3070
Other names
- Georgie Beckett
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | phoenixhouseca.org | Health Information Exchange (HIE) |
Other providers in Venice, CA
- Eric Baumgartner
- Laura Bautista
- Fanta Michelle Bayoh
- Brenda Kay Beardsley
- Jennifer Marie Beckett
- Christian Karlin( Bello
- Laura Elena Benjamin
- Kristal Diane Bent
- Olivia Rebecca Berman
- Estefania Bernabe
All providers in Venice, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.