Active NPI
David Joseph Mazaleski, LCAS
- Addiction (Substance Use Disorder) Counselor
- Rutherford College, NC
National Provider Identifier
1790724573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 380
- Practice address
- 1131-B Malcolm Blvd.
Rutherford College, NC 28671 - Phone
- (828) 874-5511
- Fax
- (828) 874-5511
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 380 | NC | Primary |
Addresses
Primary practice location
1131-B Malcolm Blvd.
Rutherford College, NC 28671
Mailing address
PO Box 247
Rutherford College, NC 28671
Phone (828) 874-5511
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6111754 | Medicaid | NC |
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 |
|---|---|---|---|
| 380 | NC | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222905600000",
"number": "1790724573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 247",
"city": "RUTHERFORD COLLEGE",
"state": "NC",
"postal_code": "28671",
"telephone_number": "828-874-5511",
"fax_number": "828-874-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1131-B MALCOLM BLVD.",
"city": "RUTHERFORD COLLEGE",
"state": "NC",
"postal_code": "28671",
"telephone_number": "828-874-5511",
"fax_number": "828-874-5511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZALESKI",
"first_name": "DAVID",
"middle_name": "JOSEPH",
"credential": "LCAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2008-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "380",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6111754",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rutherford College, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.