Christian Carrillo, 07786-C

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1536 N Boulder Hwy # 89011
Henderson, NV 89011-4120

Phone

(725) 696-9673

Fax

(702) 558-8700

NPI assigned

May 10, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Mission Treatment Centers, Inc.

  dba Henderson Comprehensive Treatment Center

  • Methadone Clinic
  • Henderson, NV
  • NPI 1154637429
  NPD (past)
• Mission Treatment Centers, Inc.

  • Methadone Clinic
  • Scottsdale, AZ
  • NPI 1700192077
  NPD (past)
• Social Model Recovery Systems, Inc.

  • Community/Behavioral Health Agency
  • Covina, CA
  • NPI 1497834089
  NPD (past)
• Social Model Recovery Systems, Inc.

  dba River Community Covina

  • Community/Behavioral Health Agency
  • Covina, CA
  • NPI 1508994369
  NPD (past)

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

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1578129060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 N BOULDER HWY # 89011",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890114120",
            "telephone_number": "725-696-9673",
            "fax_number": "702-558-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 N BOULDER HWY # 89011",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890114120",
            "telephone_number": "725-696-9673",
            "fax_number": "702-558-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "CHRISTIAN",
        "credential": "07786-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-10",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "07786-C",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candido Carrasco
• Arisha Marie Abana Carreon, DO
• Crystal Carrigan
• Felicia Carrigan, MFT -INTERNS
• Jaime Denise Carrigan, CPNP-PC
• Ivon Carrillo
• Dale Carrison, DO
• Bernadette Carrizzo
• Tiffany Carrothers, RT(N)
• Akire Carter

• Addiction (Substance Use Disorder) Counselor in Henderson, NV
• Providers in Henderson, NV by specialty
• Addiction (Substance Use Disorder) Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.