Active NPI
Mitchell Cameron Reisler, LPC
- Professional Counselor
- Gilbert, AZ
National Provider Identifier
1073252664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-21037
- Practice address
- 5656 S Power Rd Ste C140
Gilbert, AZ 85295-8480 - Phone
- (480) 252-5152
- NPI assigned
- Jun 1, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LAC-17236 | AZ | |
| Professional Counselor | 101YP2500X | LPC-21037 | AZ | Primary |
Addresses
Primary practice location
5656 S Power Rd Ste C140
Gilbert, AZ 85295-8480
Mailing address
5656 S Power Rd Ste C140
Gilbert, AZ 85295-8480
Phone (480) 252-5152
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAC-17236 | AZ | MD | Professional Counselor |
| LPC-21037 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656288000000",
"number": "1073252664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5656 S POWER RD STE C140",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852958480",
"telephone_number": "480-252-5152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5656 S POWER RD STE C140",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852958480",
"telephone_number": "480-252-5152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REISLER",
"first_name": "MITCHELL",
"middle_name": "CAMERON",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-01",
"last_updated": "2022-06-27",
"certification_date": "2022-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LAC-17236",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-21037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.