Active NPI
Michael Webster, RADT-1
- Addiction (Substance Use Disorder) Counselor
- Grass Valley, CA
National Provider Identifier
1992179311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R1214720915
- Practice address
- 180 Sierra College Dr
Grass Valley, CA 95945-5768 - Phone
- (530) 271-1140
- Fax
- (530) 271-7036
- NPI assigned
- Nov 23, 2015
- Last updated
- Nov 23, 2015
- Sex
- Male
- 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 | R1214720915 | CA | Primary |
Addresses
Primary practice location
180 Sierra College Dr
Grass Valley, CA 95945-5768
Mailing address
180 Sierra College Dr
Grass Valley, CA 95945-5768
Phone (530) 271-1140
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 |
|---|---|---|---|
| R1214720915 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Granite Wellness Centers | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Grass Valley Campus
- Community/Behavioral Health Agency
- Grass Valley, CA
- NPI 1750500237
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448236800000",
"number": "1992179311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 SIERRA COLLEGE DR",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959455768",
"telephone_number": "530-271-1140",
"fax_number": "530-271-7036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 SIERRA COLLEGE DR",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959455768",
"telephone_number": "530-271-1140",
"fax_number": "530-271-7036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEBSTER",
"first_name": "MICHAEL",
"credential": "RADT-1",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-23",
"last_updated": "2015-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1214720915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grass Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.