Roger Orazio Cangialosi, LLP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

C01090 Issued in MI

Practice address

960 Rodeo Way
Hualapai Health Department
Peach Springs, AZ 86434

Phone

(928) 769-2216

NPI assigned

Mar 16, 2009

Last updated

Oct 21, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256083200000",
    "number": "1295976660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2639 VALENTINE AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014713",
            "telephone_number": "928-377-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 RODEO WAY",
            "address_2": "HUALAPAI HEALTH DEPARTMENT",
            "city": "PEACH SPRINGS",
            "state": "AZ",
            "postal_code": "86434",
            "telephone_number": "928-769-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANGIALOSI",
        "first_name": "ROGER",
        "middle_name": "ORAZIO",
        "name_prefix": "Mr.",
        "credential": "LLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-16",
        "last_updated": "2009-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C01090",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013603",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee F Been
• Daniel Robert Boardman, PHARM.D.
• Jenifer Bowles
• David Michael Brehmeyer, M.ED./LISAC
• William M Brewer, M.D.
• Alyce Crozier, MEDICAL SUPPORT CLER
• Ernestine Alva Crozier
• Amy Elaine Dashee
• DHHS IHS Phoenix Area (Peach Springs Health Center)
• DHHS IHS Phoenix Area (Peach Springs Health Center)

• Addiction (Substance Use Disorder) Counselor in Peach Springs, AZ
• Providers in Peach Springs, AZ by specialty
• Addiction (Substance Use Disorder) Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.