Individual provider Active NPI

Silvia Teresa Gallo Vazquez, LPC

  • Mental Health Counselor
  • Phoenix, AZ
National Provider Identifier
1104998533
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC11801 Issued in AZ
Practice address
5745 W Campbell Ave
Phoenix, AZ 85031-1842
Phone
(602) 999-7898
Fax
(480) 820-7863
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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 LPC11801 AZ Primary

Addresses

Primary practice location

5745 W Campbell Ave
Phoenix, AZ 85031-1842

Mailing address

13415 W Citrus CT
Litchifield Park, AZ 85340
Phone (602) 999-7898

Other identifiers 2

IdentifierTypeStateIssuer
LISAC10617OtherAZTHERAPIST
LPC11801OtherAZTHERAPIST

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
LPC11801AZMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1104998533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13415 W CITRUS CT",
            "city": "LITCHIFIELD PARK",
            "state": "AZ",
            "postal_code": "85340",
            "telephone_number": "602-999-7898",
            "fax_number": "480-820-7863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5745 W CAMPBELL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850311842",
            "telephone_number": "602-999-7898",
            "fax_number": "480-820-7863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLO VAZQUEZ",
        "first_name": "SILVIA",
        "middle_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC11801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THERAPIST",
            "identifier": "LISAC10617",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THERAPIST",
            "identifier": "LPC11801",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.