BREAKING THE CYCLE OF ADDICTION (NPI# 1598227910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598227910 |
| Entity Type | Organization |
| Organization Name | BREAKING THE CYCLE OF ADDICTION |
| Other Organization Name | BREAKING THE CYCLE OF ADDICTION |
| Practice Address |
6011 Stacy Ave Sacramento CA 95823-3945 |
| Practice Telephone | 9165831035 |
| Mailing Telephone | 9165831035 |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2020-02-20 |
| Authorized Official Name | MR. MARION CORNELIUS WOLFE JR. (PRESIDENT) |
| Authorized Official Telephone | 9165831035 |
| Authorized Official Credential | MSW/ACSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | NPI-PERSONAL | 1780942334 | 01 |
| Other Name | Type Code |
|---|---|
| BREAKING THE CYCLE OF ADDICTION | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6011 Stacy Ave, Sacramento, CA 958233945 | 9165831035 |
| Street Address |
6011 STACY AVE |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95823-3945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343422 | Renee Yvonne Friesner | Registered Nurse | 6965 65th Street, Sacramento, CA 95823 | 2020-10-12 |
| 1790392165 | Amanda Moore | Technician | 6445 Village Center Dr, Building 7 Apt 101, Sacramento, CA 95823 | 2020-09-29 |
| 1114562766 | Daniel & Max, LLC | Optometrist | 4200 Florin Road, Suite C, Florin, CA 95823 | 2019-11-07 |
| 1396393823 | Lannon Hope Gustafson | Counselor | 8573 E Southgate Dr., Sacramento, CA 95823 | 2019-08-28 |
| 1932768280 | Sprenger Behavioral Medicine, Inc | Psychiatry & Neurology | 7601 Hospital Drive Suite 202, Suite 202, Sacramento, CA 95823 | 2019-06-11 |
| 1306316880 | Evin Johnson | Case Manager/Care Coordinator | 7000 Franklin Blvd Suite 625, Sacramento, CA 95823 | 2018-11-28 |
| 1902373095 | Alexandra L Bourcy | Family Medicine | 7275 E Southgate Dr Ste 204-206, Sacramento, CA 95823 | 2018-10-27 |
| 1891298923 | Nicholas Joseph Henderson | Behavior Technician | 6500 47th Street Apt#76, Sacramento, CA 95823 | 2018-03-15 |
| 1427567098 | Luz Maria Udave | Behavior Technician | 5435 Mack Rd Apt 87, Sacramento, CA 95823 | 2017-09-26 |
| 1417474743 | Elizabeth Smithers | Behavior Technician | 5545 Sky Parkway #202, Sacramento, CA 95823 | 2017-08-28 |
| Find all providers in zip 95823 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508472440 | Jamie Lee Byrnes | Counselor | 777 12th St Ste 250, Sacramento, CA 95814-1929 | 2020-09-16 |
| 1104431519 | Sally Kathleen Montazer | Counselor | 1134 Clinton Rd, Sacramento, CA 95825-7304 | 2020-09-11 |
| 1255958187 | Douglas Benjamin Gudeman | Counselor | Alternative House-residential Treatment Center, 1550 Juliesse Avenue, Sacramento, CA 95815 | 2020-06-26 |
| 1972127611 | Brianna Hope Barron | Counselor | 8950 Cal Center Dr Ste 160&165, Sacramento, CA 95826-3259 | 2020-05-28 |
| 1699398420 | Selena Marie Brown | Counselor | 8084 Weeping Willow Ln, Sacramento, CA 95828-5395 | 2020-05-27 |
| 1346863222 | Erin Harris | Counselor | 2819 Norcade Cir Apt 1, Sacramento, CA 95826-3427 | 2020-05-26 |
| 1023638566 | Marta Yomara Rodriguez | Counselor | 5311 College Oak Dr Apt 16, Sacramento, CA 95841-2575 | 2020-04-24 |
| 1033739321 | Yancey Outreach International Inc. | Counselor | 1457 Dreamy Way, Sacramento, CA 95835-1761 | 2020-04-16 |
| 1114554136 | Cassandra Arlene Del Toro Ruiz | Counselor | 2403 Yreka Ave # 15, Sacramento, CA 95822-4466 | 2020-03-27 |
| 1952931487 | Anisa Sims | Counselor | 2688 Stonecreek Dr Apt 137, Sacramento, CA 95833 | 2020-01-23 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95823 |
Please comment or provide details below to improve the information on BREAKING THE CYCLE OF ADDICTION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.