Kimberly Lauren Greenwood, LISAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LISAC-155279 Issued in AZ

Practice address

6262 E Broadway Rd Ste 110
Mesa, AZ 85206-6101

Phone

(480) 210-5570

NPI assigned

Jun 9, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Mavie LLC

  • Family Medicine Physician
  • La Pine, OR
  • NPI 1366270365

  AZ

  Medicare reassignment

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1043994197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6262 E BROADWAY RD STE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852066101",
            "telephone_number": "480-210-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6262 E BROADWAY RD STE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852066101",
            "telephone_number": "480-210-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWOOD",
        "first_name": "KIMBERLY",
        "middle_name": "LAUREN",
        "credential": "LISAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-09",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-155279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daryl Greenhall, PA
• Madeline Amelia Greenlief, PA
• Scott David Michael Greenman, D.O.
• Rachael Greensides, PMHNP-BC
• Greenwood Counseling PLLC
• Jessica Elizabeth Greer, FNP
• Greg Alaestante DO PC
• Kaitlyn Claire Grega, RBT
• Gregg Smith D.O., P.C.
• Jayce Gregg

• Addiction (Substance Use Disorder) Counselor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Addiction (Substance Use Disorder) Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.