Michael Carlyle, CADC-CS, ICCS, CCDS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CS0920517 Issued in CA

Practice address

28184 Tierra Vista Rd
Temecula, CA 92592-3075

Phone

(949) 228-8478

NPI assigned

Apr 22, 2021

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

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.

• Mountain Sky Recovery, LLC

  • Substance Abuse Rehabilitation Facility
  • Murrieta, CA
  • NPI 1366247207
  NPD Authorized official
• Mountain Sky Recovery, LLC

  • Substance Abuse Rehabilitation Facility
  • Murrieta, CA
  • NPI 1497486526
  NPD Authorized official

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1902488679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28184 TIERRA VISTA RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925923075",
            "telephone_number": "949-228-8478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28184 TIERRA VISTA RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925923075",
            "telephone_number": "949-228-8478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLYLE",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CADC-CS, ICCS, CCDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CS0920517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norberto Mata Carlos, LCSW
• Deanna Carlsberg, PA-C
• Mark Andrew Carlson, NMD, HHP, CMT, MST
• Antonia Carlton
• Melissa Carlton, PA-C
• Alexis Carmona
• Khynesia Carney, LVN
• Carol Cole LCSW Apc
• Jaclyn Ann Carr-Mendez, AMFT
• Dustin Carr

• Addiction (Substance Use Disorder) Counselor in Temecula, CA
• Providers in Temecula, 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 Apr 22, 2021; 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.