Ametra Carrol-Castaneda, CADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

28786 Issued in IL

Practice address

2701 17TH St
Rock Island, IL 61201-5351

Phone

(309) 779-3013

Fax

(309) 779-2078

NPI assigned

Aug 11, 2016

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 11, 2016.

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1992259584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 VALLEY DR",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612016939",
            "telephone_number": "309-373-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "309-779-3013",
            "fax_number": "309-779-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROL-CASTANEDA",
        "first_name": "AMETRA",
        "credential": "CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "28786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julian Carabajal Jr.
• Peter D Caras, DDS
• Janet Carlson, R.N.
• Patrick Carlson, LCSW
• Joseph E Carnahan, D.D.S.
• Chelsea Cauri, Michelle Carter
• Deambuir Carter
• Catholic Charities Dop
• Catholic Charities of the Diocese of Peoria
• Yan Cen

• All providers in Rock Island, IL
• Addiction (Substance Use Disorder) Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.