Individual provider Active NPI

Susana Perez-Abreu, LPC

  • Professional Counselor
  • Nogales, AZ
National Provider Identifier
1104564558
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC23135 Issued in AZ
Practice address
1852 N Mastick Way
Nogales, AZ 85621-1063
Phone
(520) 375-5000
Fax
(520) 281-1112
NPI assigned
May 25, 2022
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC23135 AZ Primary
Mental Health Counselor 101YM0800X LAC-19485 AZ

Addresses

Primary practice location

1852 N Mastick Way
Nogales, AZ 85621-1063

Mailing address

825 N Grand Ave Ste 100
Nogales, AZ 85621-1061
Phone (520) 761-2128

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
I20240703000455 AZ Practitioner - Other (Non-Physician) 5799229514 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LAC-19485AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mariposa Community Health Center, Inc CurrentSince Jun 1, 2024 Accepting new patients
Mariposa Community Health Center, Inc Mental Health Current Accepting new patients
Mariposa Community Health Center, Inc Mental Health Current Accepting new patients
Mariposa Community Health Center, Inc Past Accepting new patients

Locations

1835 N Mastick Way
Nogales, AZ 85621
Phone (520) 375-5000

1852 N Mastick Way
Nogales, AZ 85621

507 N Western Ave
Nogales, AZ 85621
Phone (520) 229-0085

3231 N Grand Ave
Nogales, AZ 85621
Phone 52076121331180

825 N Grand Ave
Ste 100
Nogales, AZ 85621
Phone (520) 761-2128

1209 W Target Range Rd
Nogales, AZ 85621
Phone (520) 285-3135

1103 Circulo Mercado
Rio Rico, AZ 85648
Phone 5202811550 ext. 1180

Interoperability endpoints

  • Direct secure messaging: susana.perezabreu.p1@direct.azch.nextgenshare.com

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": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1104564558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N GRAND AVE STE 100",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211061",
            "telephone_number": "520-761-2128",
            "fax_number": "520-281-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1852 N MASTICK WAY",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211063",
            "telephone_number": "520-375-5000",
            "fax_number": "520-281-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-ABREU",
        "first_name": "SUSANA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-25",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC23135",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-19485",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nogales, AZ

Sources for this page

Verify at the official NPI Registry.