Active NPI
Susan Self
- Professional Counselor
- Peoria, AZ
National Provider Identifier
1134521370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-0947
- Practice address
- 13460 N 94TH Dr
Suite J2
Peoria, AZ 85381-4835 - Phone
- (623) 487-7763
- Fax
- (623) 486-8276
- NPI assigned
- Sep 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-0947 | AZ | Primary |
Addresses
Primary practice location
13460 N 94TH Dr
Suite J2
Peoria, AZ 85381-4835
Mailing address
8292 E Cortez Dr
Scottsdale, AZ 85260-5668
Phone (623) 680-5634
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 |
|---|---|---|---|
| LPC-0947 | AZ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Desert View Counseling and Consulting, Inc. | Professional | Past | Accepting new patients |
| Desert View Counseling and Consulting, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Peoria, AZ
- NPI 1124173471
Professional
-
- Community/Behavioral Health Agency
- Peoria, AZ
- NPI 1730553496
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410998400000",
"number": "1134521370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8292 E CORTEZ DR",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852605668",
"telephone_number": "623-680-5634",
"fax_number": "480-661-9024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13460 N 94TH DR",
"address_2": "SUITE J2",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853814835",
"telephone_number": "623-487-7763",
"fax_number": "623-486-8276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELF",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-18",
"last_updated": "2014-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-0947",
"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 Sep 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.