Carol Roddy, CSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

11055 - 132 Issued in WI

Practice address

108 N Lincoln Ave
Beaver Dam, WI 53916-2110

Phone

(920) 887-9549

Fax

(920) 887-3977

NPI assigned

Jul 26, 2016

Sex

Female

Sole proprietor

Yes

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.

• Affiliated Counseling Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beaver Dam, WI
  • NPI 1164568879
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

• Carol Horwath Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 26, 2016.

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1912450909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N LINCOLN AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162110",
            "telephone_number": "920-887-9549",
            "fax_number": "920-887-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N LINCOLN AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162110",
            "telephone_number": "920-887-9549",
            "fax_number": "920-887-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODDY",
        "first_name": "CAROL",
        "credential": "CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "11055 - 132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "HORWATH",
            "credential": "CSAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Courtney Rae Retzlaff, M.S. CCC-SLP
• J Scott Rhule, MA, LCSW, CSAC, ICS
• Richard P. Jennings D.O. S. C.
• Joel Riehbrandt
• Carly Riley
• Raquel Rodriguez-Guzman, PHARMD
• Misty M Romero Rivera, APNP
• Natalie Ross, DNP, FNP-BC, RN
• Diane Marie Rundle, WHNP
• RWH Investments LLC

• All providers in Beaver Dam, WI
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.