Stephanie Carlson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

168651 Issued in CA

Practice address

768 Pleasant Valley Rd
Diamond Springs, CA 95619-9260

Phone

(530) 621-6130

NPI assigned

Aug 8, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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.

• El Dorado County Mental Health

  • Point of Service
  • Diamond Springs, CA
  • NPI 1063838076
  NPD (past)
• El Dorado County Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Diamond Springs, CA
  • NPI 1316158082
  NPD (past)

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1750806949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "768 PLEASANT VALLEY RD",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199260",
            "telephone_number": "530-621-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "768 PLEASANT VALLEY RD",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199260",
            "telephone_number": "530-621-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "168651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Teresa Bilyeu
• James Allen Blackburn, LMFT
• Dorothy Caluza
• Krista Kay Campbell
• John Carberry II, M.S.
• Jessica Lourdes Casillas
• Crystal Martha Castech-Tobias
• Joshua Emmanuel Castro
• Kyle Chamberlain
• Benjamin Clover, LPCC

• Addiction (Substance Use Disorder) Counselor in Diamond Springs, CA
• Providers in Diamond Springs, 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 21, 2022; 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.