NPIMap

Individual provider Active NPI

Laura Hornback

  • Mental Health Counselor
  • Peoria, AZ
National Provider Identifier
1093188138
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
BH4687 Issued in AZ
Practice address
7402 W Shangri la Rd
Peoria, AZ 85345-5812
Phone
(623) 979-8446
NPI assigned
Nov 11, 2015
Last updated
Nov 11, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2015

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 BH4687 AZ Primary

Addresses

Primary practice location

7402 W Shangri la Rd
Peoria, AZ 85345-5812

Mailing address

8408 W Willow Avenue
Peoria, AZ 85381
Phone (623) 418-6657

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

LicenseStateTypeSpecialty
BH4687AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Loloma House LLC Past Accepting new patients
Loloma Houses LLC PastSince Mar 22, 2020 Accepting new patients

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": "1447200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1093188138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8408 W WILLOW AVENUE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "85381",
            "telephone_number": "623-418-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7402 W SHANGRI LA RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853455812",
            "telephone_number": "623-979-8446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNBACK",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-11",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "BH4687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.