Individual provider Active NPI

Charles Hugh McLellan

  • Addiction (Substance Use Disorder) Counselor
  • Carmichael, CA
National Provider Identifier
1619156601
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
3637 Mission Ave BLDG B
Carmichael, CA 95608
Phone
(916) 485-4175
NPI assigned
Oct 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Student in an Organized Health Care Education/Training Program 390200000X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

3637 Mission Ave BLDG B
Carmichael, CA 95608

Mailing address

3637 Mission Ave BLDG B
Carmichael, CA 95608-2946
Phone (916) 485-4175

Other practice location 1

4600 47th Ave Ste 102
Sacramento, CA 95824-3923
Phone (916) 454-4242

Other practice location 2

4600 47th Ave Ste 102
Sacramento, CA 95824-3923
Phone (916) 454-4242

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

OrganizationSpecialtyStatusNew patients
Sustainable Wellness Solutions 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.

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1619156601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3637 MISSION AVE BLDG B",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956082946",
            "telephone_number": "916-485-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 MISSION AVE BLDG B",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "95608",
            "telephone_number": "916-485-4175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 47th Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958243923",
            "country_code": "US",
            "telephone_number": "916-454-4242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4600 47th Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958243923",
            "country_code": "US",
            "telephone_number": "916-454-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLELLAN",
        "first_name": "CHARLES",
        "middle_name": "HUGH",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-26",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "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": []
}

Other providers in Carmichael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.