Active NPI
Kevin Douglas Halligan
- Addiction (Substance Use Disorder) Counselor
- San Diego, CA
National Provider Identifier
1972461614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 15876
- Practice address
- 1501 Imperial Ave
San Diego, CA 92101-7638 - Phone
- (541) 480-6643
- NPI assigned
- Jan 12, 2026
- Sex
- Male
- Sole proprietor
- Yes
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 | 15876 | CA | Primary |
Addresses
Primary practice location
1501 Imperial Ave
San Diego, CA 92101-7638
Mailing address
1501 Imperial Ave
San Diego, CA 92101-7638
Phone (541) 480-6643
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 |
|---|---|---|---|
| 15876 | CA | MD | Hand Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1768176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768867200000",
"number": "1972461614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 IMPERIAL AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921017638",
"telephone_number": "541-480-6643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 IMPERIAL AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921017638",
"telephone_number": "541-480-6643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLIGAN",
"first_name": "KEVIN",
"middle_name": "DOUGLAS",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-01-12",
"last_updated": "2026-01-20",
"certification_date": "2026-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "15876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.