Elizabeth Athens, LMSW
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Mesa, AZ
NPI 1174820757 · NPPES record last updated Feb 17, 2011
Key facts
- NPI
- 1174820757
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- LMSW12893 (AZ)
- Practice address
- 554 S Bellview
Mesa, AZ 85204-2504 - Phone
- (480) 461-1711
- Fax
- (480) 833-5772
- NPI assigned
- Feb 17, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW12893 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LMSW12893 | AZ | Yes |
Addresses
Primary practice location
554 S Bellview
Mesa, AZ 85204-2504
Mailing address
554 S Bellview
Mesa, AZ 85204-2504
Phone (480) 461-1711
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All providers in Mesa, AZ · Addiction (Substance Use Disorder) Counselor in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.