Carrie Ann Phillips, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

306462 Issued in MN

Practice address

831 Commonwealth Ave
Duluth, MN 55808-1913

Phone

(612) 759-5742

NPI assigned

Aug 23, 2022

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

Other names 1

• Carrie Ann Macintosh Former name

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.

• The Recovery Connect LLC

  • Addiction (Substance Use Disorder) Counselor
  • Duluth, MN
  • NPI 1801514625
  NPD Authorized official

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1801515002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 MAYWOOD ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551174133",
            "telephone_number": "612-759-5742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 COMMONWEALTH AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558081913",
            "telephone_number": "612-759-5742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CARRIE",
        "middle_name": "ANN",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "306462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "MACINTOSH",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Napoleon Petsoulis
• Haeli Anne Pettis
• Durae June Pfeffer
• Paige Elizabeth Pfeifer
• Raelyn Mae Phelps
• Rachel Leigh Phillips, MSW, LGSW, LADC
• Steven Peter Phillipson
• Austin Edward Pickup, MD
• Jake Darren Pierce-Walsh, MSW, LICSW
• Amanda Pierre

• Addiction (Substance Use Disorder) Counselor in Duluth, MN
• Providers in Duluth, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.