Active NPI
Monica Dizick, CADC I
- Addiction (Substance Use Disorder) Counselor
- Bend, OR
National Provider Identifier
1922582519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 1435 NE 4TH St Ste B
Bend, OR 97701-4268 - Phone
- (541) 306-4446
- Fax
- (541) 550-2011
- NPI assigned
- Sep 19, 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 | OR | Primary |
Addresses
Primary practice location
1435 NE 4TH St Ste B
Bend, OR 97701-4268
Mailing address
1435 NE 4TH St Ste B
Bend, OR 97701-4268
Phone (541) 306-4446
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18-06-06 | Other | OR | STATE OF OREGON ACCBO |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537315200000",
"number": "1922582519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1435 NE 4TH ST STE B",
"city": "BEND",
"state": "OR",
"postal_code": "977014268",
"telephone_number": "541-306-4446",
"fax_number": "541-550-2011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1435 NE 4TH ST STE B",
"city": "BEND",
"state": "OR",
"postal_code": "977014268",
"telephone_number": "541-306-4446",
"fax_number": "541-550-2011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIZICK",
"first_name": "MONICA",
"name_prefix": "Ms.",
"credential": "CADC I",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-19",
"last_updated": "2018-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF OREGON ACCBO",
"identifier": "18-06-06",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.