Tiodolo Delagarza III, SAC-IT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

17036-130 Issued in WI

Practice address

1111 S 6TH St
Milwaukee, WI 53204-2301

Phone

(414) 643-8530

Fax

(414) 647-8602

NPI assigned

Jul 3, 2014

Sex

Male

Sole proprietor

No

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.

• Faith Factory LLC

  • Professional Counselor
  • Milwaukee, WI
  • NPI 1265151906
  NPD (past)

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404345600000",
    "number": "1962818542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 S 6TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042301",
            "telephone_number": "414-643-8530",
            "fax_number": "414-647-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S 6TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042301",
            "telephone_number": "414-643-8530",
            "fax_number": "414-647-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAGARZA",
        "first_name": "TIODOLO",
        "name_suffix": "III",
        "credential": "SAC-IT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-03",
        "last_updated": "2014-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17036-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Dekoch, MS
• Leah Marie Del Gaudio, N.P.
• Del Mar Pharmacy SC
• Melissa Lynn Del Rosario, LPC
• David Del Toro, MD
• Joshua Delahan, MSW
• Stephen P Delahunt, MD
• Tara Marie Delamarter, PA-C
• Andrienne M Delaney, APNP
• Brian N Delaney, LMT

• Addiction (Substance Use Disorder) Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• 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 3, 2014; 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.