Active NPI
Patricia L. Cavanagh, L.P.N., L.I.S.A.C.
- Counselor
- Cottonwood, AZ
National Provider Identifier
1235474875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPC#10043
- Practice address
- 849 Cove Pkwy
Suite a
Cottonwood, AZ 86326-4682 - Phone
- (928) 639-4389
- NPI assigned
- Dec 9, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPC#10043 | AZ | Primary |
| Counselor | 101Y00000X | LISAC#1435 | AZ |
Addresses
Primary practice location
849 Cove Pkwy
Suite a
Cottonwood, AZ 86326-4682
Mailing address
849 Cove Pkwy
Suite a
Cottonwood, AZ 86326-4682
Phone (928) 639-4389
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 |
|---|---|---|---|
| LISAC#1435 | AZ | MD | Counselor |
| LPC#10043 | AZ | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355011200000",
"number": "1235474875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "849 COVE PKWY",
"address_2": "SUITE A",
"city": "COTTONWOOD",
"state": "AZ",
"postal_code": "863264682",
"telephone_number": "928-639-4389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "849 COVE PKWY",
"address_2": "SUITE A",
"city": "COTTONWOOD",
"state": "AZ",
"postal_code": "863264682",
"telephone_number": "928-639-4389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVANAGH",
"first_name": "PATRICIA",
"middle_name": "L.",
"credential": "L.P.N., L.I.S.A.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-12-09",
"last_updated": "2012-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AZ",
"license": "LPC#10043",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AZ",
"license": "LISAC#1435",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cottonwood, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.