Active NPI
Atticus Carr, LCSW
- Case Manager/Care Coordinator
- San Jose, CA
National Provider Identifier
1356727648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- LCS 26042
- Practice address
- 2400 Moorpark Avenue 316B
San Jose, CA 95128 - Phone
- (408) 885-7587
- NPI assigned
- Aug 10, 2015
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | LCS 26042 | CA | Primary |
Addresses
Primary practice location
2400 Moorpark Avenue 316B
San Jose, CA 95128
Mailing address
2400 Moorpark Avenue 316B
San Jose, CA 95128
Phone (408) 885-7587
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS 26042 | CA | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439164800000",
"number": "1356727648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 MOORPARK AVENUE 316B",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95128",
"telephone_number": "408-885-7587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 MOORPARK AVENUE 316B",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95128",
"telephone_number": "408-885-7587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARR",
"first_name": "ATTICUS",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-10",
"last_updated": "2015-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "CA",
"license": "LCS 26042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.