Michael Alan Lazarus Sr., CATC-II, CAODC-A

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

525 Grand Ave
Spring Valley, CA 91977-5933

Phone

(619) 488-7612

Fax

(619) 327-5410

NPI assigned

Jul 31, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Training Center Ephesians 4:11-16

  • Substance Abuse Rehabilitation Facility
  • Spring Valley, CA
  • NPI 1639665516
  NPD (past) Authorized official

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1508410259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 GRAND AVE",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919775933",
            "telephone_number": "619-488-7612",
            "fax_number": "619-327-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 GRAND AVE",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919775933",
            "telephone_number": "619-488-7612",
            "fax_number": "619-327-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARUS",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "CATC-II, CAODC-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "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": "HEALTHCARE PROVIDERS SERVICE ORGANIZATION",
            "identifier": "0415192210",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://med1.neocertifiedmail.com/",
            "affiliation": "N",
            "address_1": "525 Grand Ave",
            "city": "Spring Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "919775933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Spring Valley, CA
• Providers in Spring Valley, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.