NPIMap

Organization Active NPI

Creosote Mental Health Group

  • Counseling Psychologist
  • Tucson, AZ
National Provider Identifier
1811509581
Registry record updated Aug 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
CREOSOTE MENTAL HEALTH GROUP
Practice address
4646 N Swan Rd Ste 105
Tucson, AZ 85718-6715
Phone
(520) 307-6495
NPI assigned
Aug 23, 2020
Last updated
Aug 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2020

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

Authorized official

Name
Dr. Chad Mosher, PHDNPI 1053801316
Title
Founder/Director
Phone
(520) 307-6495

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU
Psychologist 103T00000X NU
Counseling Psychologist 103TC1900X NU Primary
Community Health Worker 172V00000X NU

Addresses

Primary practice location

4646 N Swan Rd Ste 105
Tucson, AZ 85718-6715

Mailing address

1327 E Zulema Loop
Tucson, AZ 85706-4415
Phone (520) 307-6495

Other identifiers 2

IdentifierTypeStateIssuer
1053801316OtherAZGENERAL
1053801316MedicaidAZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1598140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598140800000",
    "number": "1811509581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 E ZULEMA LOOP",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857064415",
            "telephone_number": "520-307-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 N SWAN RD STE 105",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186715",
            "telephone_number": "520-307-6495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREOSOTE MENTAL HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-23",
        "last_updated": "2020-08-23",
        "certification_date": "2020-08-23",
        "status": "A",
        "authorized_official_last_name": "MOSHER",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "FOUNDER/DIRECTOR",
        "authorized_official_telephone_number": "520-307-6495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL",
            "identifier": "1053801316",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053801316",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

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

Verify at the official NPI Registry.