Individual provider · Type 1 NPI
Charles Tyler Upton, LISAC, PLC
Addiction (Substance Use Disorder) Counselor · Tucson, AZ
NPI number
1104136571
Active
Practice location
721 N. Fourth Ave
Tucson, AZ 85705
Fax (520) 202-1889
Mailing address
1650 E. Fort Lowell Rd, Ste 202
Tucson, AZ 85719-2378
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | LISAC10856 (AZ) |
| Professional Counselor | 101YP2500X | LPC11260 (AZ) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Another provider at this address
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About NPI 1104136571
Charles Tyler Upton, LISAC, PLC's National Provider Identifier is 1104136571, issued on Oct 19, 2010. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Tucson, AZ. The record was last updated on Oct 19, 2010.