Active NPI
Lisa Marie Myruski, MA, CADC-II
- Addiction (Substance Use Disorder) Counselor
- Alameda, CA
National Provider Identifier
1346704368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- RA8820917
- Practice address
- 1516 Oak St Ste 310
Alameda, CA 94501-2958 - Phone
- (510) 255-2156
- NPI assigned
- Jan 23, 2019
- Sex
- Female
- 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 | RA8820917 | CA | Primary |
Addresses
Primary practice location
1516 Oak St Ste 310
Alameda, CA 94501-2958
Mailing address
2815 Santa Clara Ave
Alameda, CA 94501-3013
Phone (646) 226-2333
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RA8820917 | 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": "1548201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548201600000",
"number": "1346704368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2815 SANTA CLARA AVE",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945013013",
"telephone_number": "646-226-2333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1516 OAK ST STE 310",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945012958",
"telephone_number": "510-255-2156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYRUSKI",
"first_name": "LISA",
"middle_name": "MARIE",
"credential": "MA, CADC-II",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-23",
"last_updated": "2019-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "RA8820917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alameda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.