Active NPI
Mickie Marchetti
- Addiction (Substance Use Disorder) Counselor
- Antioch, CA
National Provider Identifier
1508044264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 1915 D St
Antioch, CA 94509-2571 - Phone
- (925) 754-3673
- Fax
- (925) 754-2002
- NPI assigned
- Feb 5, 2008
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
1915 D St
Antioch, CA 94509-2571
Mailing address
1915 D St
Antioch, CA 94509-2571
Phone (925) 754-3673
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07553 | Other | CA | ADOL TX BRENTWOOD |
| 56112 | Other | CA | STAFF BILLING NUMBER |
| 07536 | Other | CA | DMC ADOL ANTIOCH |
| 07556 | Other | CA | BYRON RANCH |
| 07557 | Other | CA | DMC ADOL BRENTWOOD |
| 070753 | Other | CA | MASTER PROVIDER NUMBER |
| 0753 | Other | CA | DRUG M/CAL BILLING NUM |
| 07531 | Other | CA | ADULT TX ANTIOCH |
| 07552 | Other | CA | DMC ADULT BRENTWOOD |
| 07533 | Other | CA | ADOL TX ANTIOCH |
| 07555 | Other | CA | DRUG COURT |
| 0726 | Other | CA | DRUG M/CAL BILLING NUM |
| 07534 | Other | CA | DMC ADULT ANTIOCH |
| 07551 | Other | CA | ADULT TX BRENTWOOOD |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reach Project, Inc. | 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.
-
- Community/Behavioral Health Agency
- Antioch, CA
- NPI 1417163494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202169600000",
"number": "1508044264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1915 D ST",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945092571",
"telephone_number": "925-754-3673",
"fax_number": "925-754-2002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1915 D ST",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945092571",
"telephone_number": "925-754-3673",
"fax_number": "925-754-2002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCHETTI",
"first_name": "MICKIE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-05",
"last_updated": "2008-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADOL TX BRENTWOOD",
"identifier": "07553",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STAFF BILLING NUMBER",
"identifier": "56112",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMC ADOL ANTIOCH",
"identifier": "07536",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BYRON RANCH",
"identifier": "07556",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMC ADOL BRENTWOOD",
"identifier": "07557",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASTER PROVIDER NUMBER",
"identifier": "070753",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRUG M/CAL BILLING NUM",
"identifier": "0753",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADULT TX ANTIOCH",
"identifier": "07531",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMC ADULT BRENTWOOD",
"identifier": "07552",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADOL TX ANTIOCH",
"identifier": "07533",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRUG COURT",
"identifier": "07555",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRUG M/CAL BILLING NUM",
"identifier": "0726",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMC ADULT ANTIOCH",
"identifier": "07534",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADULT TX BRENTWOOOD",
"identifier": "07551",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Antioch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.