Active NPI
Lawrence E Wells, LPC
- Mental Health Counselor
- Coolidge, AZ
National Provider Identifier
1215409487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 17554
- Practice address
- 556 S Arizona Blvd
Coolidge, AZ 85128-5106 - Phone
- (520) 723-7405
- Fax
- (520) 723-7410
- NPI assigned
- Dec 27, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 17554 | AZ | Primary |
Addresses
Primary practice location
556 S Arizona Blvd
Coolidge, AZ 85128-5106
Mailing address
18280 N Calacera St
Maricopa, AZ 85138-3879
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 |
|---|---|---|---|
| 17554 | AZ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557273600000",
"number": "1215409487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18280 N CALACERA ST",
"city": "MARICOPA",
"state": "AZ",
"postal_code": "851383879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "556 S ARIZONA BLVD",
"city": "COOLIDGE",
"state": "AZ",
"postal_code": "851285106",
"telephone_number": "520-723-7405",
"fax_number": "520-723-7410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "LAWRENCE",
"middle_name": "E",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-27",
"last_updated": "2019-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "17554",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coolidge, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.