Individual provider Active NPI

Daniel Thomas Stephens, MA, LMHC, LPC, NCC

  • Mental Health Counselor
  • Peoria, AZ
National Provider Identifier
1053720193
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC60636677 Issued in WA
Practice address
14050 N 83Rd Ave Ste 290
Peoria, AZ 85381-5650
Phone
(623) 267-5849
NPI assigned
Aug 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MC60636677 WA Primary

Addresses

Primary practice location

14050 N 83Rd Ave Ste 290
Peoria, AZ 85381-5650

Mailing address

5411 NE 107TH Ave Ste 100
Vancouver, WA 98662-6347
Phone (360) 609-8535

Other practice location 1

5411 NE 107th Ave Ste 100
Vancouver, WA 98662-6347
Phone (360) 609-8535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MC60636677WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Restored Life Counseling CurrentSince Sep 20, 2022 Accepting new patients

Locations

17230 N 59th Ave
Glendale, AZ 85308
Phone (360) 558-7663

14050 N 83rd Ave
Ste 290
Peoria, AZ 85381
Phone (623) 261-1362

5411 NE 107th Ave
Ste 100
Vancouver, WA 98662
Phone (360) 609-8535

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1406937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1053720193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 NE 107TH AVE STE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626347",
            "telephone_number": "360-609-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14050 N 83RD AVE STE 290",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815650",
            "telephone_number": "623-267-5849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5411 NE 107th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986626347",
            "country_code": "US",
            "telephone_number": "360-609-8535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "DANIEL",
        "middle_name": "THOMAS",
        "credential": "MA, LMHC, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-02",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60636677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.