Active NPI
Richard G Ciaglia, MA LISAL
- Addiction (Substance Use Disorder) Counselor
- Phoenix, AZ
National Provider Identifier
1467594085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LSAC10488
- Practice address
- 1102 W Highland Ave
Phoenix, AZ 85013-2470 - Phone
- (602) 707-2418
- Fax
- (602) 707-2040
- NPI assigned
- Feb 12, 2007
- Sex
- Male
- 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 | LSAC10488 | AZ | Primary |
Addresses
Primary practice location
1102 W Highland Ave
Phoenix, AZ 85013-2470
Mailing address
1226 W Osborn Rd
Phoenix, AZ 85013-3618
Phone (602) 707-2418
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126285 | Medicaid | AZ |
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 |
|---|---|---|---|
| LSAC10488 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osborn School District | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Local Education Agency (LEA)
- Phonix, AZ
- NPI 1487792180
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1467594085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1226 W OSBORN RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850133618",
"telephone_number": "602-707-2418",
"fax_number": "602-707-2040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1102 W HIGHLAND AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850132470",
"telephone_number": "602-707-2418",
"fax_number": "602-707-2040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIAGLIA",
"first_name": "RICHARD",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "MA LISAL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-12",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AZ",
"license": "LSAC10488",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "126285",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.