MRS. CHARISSE MARIE CARUTH-IACONO LAADC NPI 1679946479

NPI Information

NPI: 1679946479
Provider Name: MRS. CHARISSE MARIE CARUTH-IACONO, LAADC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
1625 SCHRADER BLVD
LOS ANGELES, CA
ZIP 90028
Phone: (213) 466-5042
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MRS. Charisse Marie Caruth-iacono, LAADC is an addiction (substance use disorder) counselor in Los Angeles, CA. MRS. Charisse Marie Caruth-iacono, LAADC NPI is 1679946479. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1625 SCHRADER BLVD
LOS ANGELES, CA
ZIP 90028-213
Phone: (213) 466-5042

The enumeration date for this NPI number is 11/3/2015 and was last updated on 9/30/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program		RALR8960418	CALIFORNIA	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	LCAS-21587	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01536011	OTHER	CALIFORNIA	MEDI-CAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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