Individual provider Active NPI

Roseann Bailey McCants, SUDCC III

  • Addiction (Substance Use Disorder) Counselor
  • Tustin, CA
National Provider Identifier
1396564159
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
14417 Issued in CA
Practice address
15400 Lansdowne Rd
Tustin, CA 92782-0222
Phone
(727) 247-7891
NPI assigned
Oct 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X 14417 CA Primary

Addresses

Primary practice location

15400 Lansdowne Rd
Tustin, CA 92782-0222

Mailing address

15405 Lansdowne Rd
Tustin, CA 92782-0200
Phone (727) 247-7891

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

LicenseStateTypeSpecialty
14417CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1396564159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15405 LANSDOWNE RD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927820200",
            "telephone_number": "727-247-7891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15400 LANSDOWNE RD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927820222",
            "telephone_number": "727-247-7891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCANTS",
        "first_name": "ROSEANN",
        "middle_name": "BAILEY",
        "credential": "SUDCC III",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-08",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "14417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.