Active NPI
Carlos Mackall
- Addiction (Substance Use Disorder) Counselor
- Newark, DE
National Provider Identifier
1700496205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1671
- Practice address
- 659 E Chestnut Hill Rd
Newark, DE 19713-1827 - Phone
- (252) 438-4145
- Fax
- (252) 438-6405
- NPI assigned
- Aug 9, 2020
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1671 | DE | Primary |
Addresses
Primary practice location
659 E Chestnut Hill Rd
Newark, DE 19713-1827
Mailing address
2701 N 16TH St Ste 316
Phoenix, AZ 85006-1266
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1671 | DE | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598918400000",
"number": "1700496205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 N 16TH ST STE 316",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850061266",
"fax_number": "602-636-5283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "659 E CHESTNUT HILL RD",
"city": "NEWARK",
"state": "DE",
"postal_code": "197131827",
"telephone_number": "252-438-4145",
"fax_number": "252-438-6405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKALL",
"first_name": "CARLOS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-09",
"last_updated": "2020-09-01",
"certification_date": "2020-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "DE",
"license": "1671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.