Active NPI
Darlene Grady, RADT-1
- Addiction (Substance Use Disorder) Counselor
- Carmichael, CA
National Provider Identifier
1912400490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R119560115
- Practice address
- 6127 Fair Oaks Blvd
Carmichael, CA 95608-4818 - Phone
- (916) 974-8090
- Fax
- (916) 974-7851
- NPI assigned
- Mar 12, 2018
- Sex
- Female
- Sole proprietor
- No
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 | R119560115 | CA | Primary |
Addresses
Primary practice location
6127 Fair Oaks Blvd
Carmichael, CA 95608-4818
Mailing address
6127 Fair Oaks Blvd
Carmichael, CA 95608-4818
Phone (916) 974-8090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94-2671219 | Medicaid | CA |
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 |
|---|---|---|---|
| R119560115 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520812800000",
"number": "1912400490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6127 FAIR OAKS BLVD",
"city": "CARMICHAEL",
"state": "CA",
"postal_code": "956084818",
"telephone_number": "916-974-8090",
"fax_number": "916-974-7851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6127 FAIR OAKS BLVD",
"city": "CARMICHAEL",
"state": "CA",
"postal_code": "956084818",
"telephone_number": "916-974-8090",
"fax_number": "916-974-7851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADY",
"first_name": "DARLENE",
"credential": "RADT-1",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-12",
"last_updated": "2018-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R119560115",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "94-2671219",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carmichael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.