Active NPI
Carlos G Quijada Sr., MS, LPC
- Professional Counselor
- Douglas, AZ
National Provider Identifier
1508265703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-14543
- Practice address
- 1701 N Douglas Ave
Douglas, AZ 85607-1019 - Phone
- (520) 366-3133
- Fax
- (520) 364-2770
- NPI assigned
- Aug 14, 2014
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-14543 | AZ | Primary |
Addresses
Primary practice location
1701 N Douglas Ave
Douglas, AZ 85607-1019
Mailing address
2851 S Avenue B # 4
Yuma, AZ 85364-7726
Phone (928) 376-0026
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-14543 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407974400000",
"number": "1508265703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2851 S AVENUE B # 4",
"city": "YUMA",
"state": "AZ",
"postal_code": "853647726",
"telephone_number": "928-376-0026",
"fax_number": "928-782-2298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 N DOUGLAS AVE",
"city": "DOUGLAS",
"state": "AZ",
"postal_code": "856071019",
"telephone_number": "520-366-3133",
"fax_number": "520-364-2770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUIJADA",
"first_name": "CARLOS",
"middle_name": "G",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "MS, LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-14",
"last_updated": "2014-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-14543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglas, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.