Individual provider Active NPI

Mary Specio-Boyer, LISAC, LMSW

  • Addiction (Substance Use Disorder) Counselor
  • Tucson, AZ
National Provider Identifier
1124591797
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LISAC-10130 Issued in AZ
Practice address
1477 W Commerce CT
Tucson, AZ 85746-6016
Phone
(520) 792-3293
NPI assigned
Jan 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LMSW-13175 AZ
Addiction (Substance Use Disorder) Counselor 101YA0400X LISAC-10130 AZ Primary

Addresses

Primary practice location

1477 W Commerce CT
Tucson, AZ 85746-6016

Mailing address

PO Box 1457
Tucson, AZ 85702-1457

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
LISAC-10130AZMDAddiction (Substance Use Disorder) Counselor
LMSW-13175AZMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1124591797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1457",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857021457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 W COMMERCE CT",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857466016",
            "telephone_number": "520-792-3293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPECIO-BOYER",
        "first_name": "MARY",
        "credential": "LISAC, LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LMSW-13175",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-10130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; 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.