Individual provider Active NPI

Eboni Joi Fields, LPC

  • Group Psychotherapy Psychologist
  • Phoenix, AZ
National Provider Identifier
1043853807
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
License
LPC-18562 Issued in AZ
Practice address
2435 W Kowalsky LN
Phoenix, AZ 85041-4471
Phone
(602) 741-1660
NPI assigned
Oct 24, 2019
Last updated
Jun 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy Psychologist 103TP2701X LPC-18562 AZ Primary

Addresses

Primary practice location

2435 W Kowalsky LN
Phoenix, AZ 85041-4471

Mailing address

2435 W Kowalsky LN
Phoenix, AZ 85041-4471
Phone (602) 741-1660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250408003119 AZ Practitioner - Mental Health Counselor 7012431331 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-18562AZMDGroup Psychotherapy Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Integrated Recovery CurrentSince Aug 26, 2025 Accepting new patients
Dwennimmen Counseling PLLC Current Accepting new patients
Cornerstone Healing Center, LLC Past Accepting new patients
HLGL LLC PastSince Jun 30, 2024 Accepting new patients

Locations

4040 E McDowell Rd
Ste 107
Phoenix, AZ 85008
Phone (602) 796-3484

4040 E McDowell Rd
Ste 307
Phoenix, AZ 85008
Phone (480) 631-0914

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1043853807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 W KOWALSKY LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850414471",
            "telephone_number": "602-741-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 W KOWALSKY LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850414471",
            "telephone_number": "602-741-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDS",
        "first_name": "EBONI",
        "middle_name": "JOI",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2024-06-05",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "AZ",
            "license": "LPC-18562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.