Mara Lena Carlos

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1612 E Southern Ave
Phoenix, AZ 85040-3534

Phone

(520) 907-1437

NPI assigned

Dec 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Phoenix Integrity House LLC

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1619675626
  NPD Authorized official

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

{
    "created_epoch": "1671753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1346952132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 E SOUTHERN AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850403534",
            "telephone_number": "520-907-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 E SOUTHERN AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850403534",
            "telephone_number": "520-907-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLOS",
        "first_name": "MARA",
        "middle_name": "LENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-23",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Carlisle, PA-C
• William Carlisle, OT
• Carlos Gutierrez PLLC
• Carlos Rodriguez MD PLLC
• Vanessa Carlos-Medina, FNP
• Carin M Carlsen, M.A. CCC-SLP
• Carlson & Palmer PC
• Aimee Carlson, PHARMD
• Benjmamin Thomas Carlson, PTA
• Breanna Carlson

• Addiction (Substance Use Disorder) Counselor in Phoenix, AZ
• Providers in Phoenix, 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 Dec 23, 2022; 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.