Charles L Carr, PHD, LISAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

11766 Issued in AZ

Practice address

1790 N Mastick Way
Suite D
Nogales, AZ 85621-1135

Phone

(520) 394-4295

NPI assigned

Jun 1, 2009

Last updated

Jun 1, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243814400000",
    "number": "1750517074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 N MASTICK WAY",
            "address_2": "SUITE D",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211135",
            "telephone_number": "520-394-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 N MASTICK WAY",
            "address_2": "SUITE D",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211135",
            "telephone_number": "520-394-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "CHARLES",
        "middle_name": "L",
        "credential": "PHD, LISAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-01",
        "last_updated": "2009-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "11766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA BOARD OF BEHAVIORAL HEALTH",
            "identifier": "11766",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Abigail Caballero, MA, NCC, LPC
• Swilma P Campos, RN
• Teresa Canez, LPC
• Carondelet Health Network (Holy Cross Hospital)
• Carondelet Medical Group, Inc
• Casbra Behavioral Health, Inc.
• Melinda Maricela Castillo, LISAC, AGS
• Blanca Castro, RN
• Axel Eduardo Chavez Mojica, DDS
• Rosalinda Chavez

• Addiction (Substance Use Disorder) Counselor in Nogales, AZ
• Providers in Nogales, AZ by specialty
• Addiction (Substance Use Disorder) Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; 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.