Active NPI
Elias Vasilios Magoulas, RAS
- Addiction (Substance Use Disorder) Counselor
- Ukiah, CA
National Provider Identifier
1265618599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- RAS M0804031534
- Practice address
- 1120 S Dora St
Ukiah, CA 95482-6340 - Phone
- (707) 565-6248
- Fax
- (707) 472-2307
- NPI assigned
- Jan 16, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | RAS M0804031534 | CA | Primary |
Addresses
Primary practice location
1120 S Dora St
Ukiah, CA 95482-6340
Mailing address
1120 S Dora St
Ukiah, CA 95482-6340
Phone (707) 565-6248
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 |
|---|---|---|---|
| RAS M0804031534 | 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": "1200441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353369600000",
"number": "1265618599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 S DORA ST",
"city": "UKIAH",
"state": "CA",
"postal_code": "954826340",
"telephone_number": "707-565-6248",
"fax_number": "707-472-2307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 S DORA ST",
"city": "UKIAH",
"state": "CA",
"postal_code": "954826340",
"telephone_number": "707-565-6248",
"fax_number": "707-472-2307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGOULAS",
"first_name": "ELIAS",
"middle_name": "VASILIOS",
"name_prefix": "Mr.",
"credential": "RAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-16",
"last_updated": "2012-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "RAS M0804031534",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.