Healthcare Provider Details

I. General information

NPI: 1902574460
Provider Name (Legal Business Name): COUNCIL ON ALCOHOLISM AND DRUG ABUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 S C ST STE A
LOMPOC CA
93436-7339
US

IV. Provider business mailing address

PO BOX 28
SANTA BARBARA CA
93102-0028
US

V. Phone/Fax

Practice location:
  • Phone: 805-963-1433
  • Fax:
Mailing address:
  • Phone: 805-963-1433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CAROL CELIC
Title or Position: CONTRACTS GRANTS EHR MANAGER
Credential:
Phone: 805-722-1316