Individual provider Active NPI

Ada Ruth Nelson, LAC

  • Addiction (Substance Use Disorder) Counselor
  • Sun City, AZ
National Provider Identifier
1245380666
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LISAC-155255 Issued in AZ
Practice address
18434 N 99TH Ave Ste 8
Sun City, AZ 85373-1672
Phone
(623) 248-4104
Fax
(623) 248-4943
NPI assigned
Jan 10, 2007
Last updated
Jan 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 423 LA
Addiction (Substance Use Disorder) Counselor 101YA0400X LISAC-155255 AZ Primary
Social Worker 104100000X 9400 LA

Addresses

Primary practice location

18434 N 99TH Ave Ste 8
Sun City, AZ 85373-1672

Mailing address

4440 General Meyer Ave
New Orleans, LA 70131-3529
Phone (504) 361-6500

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-155255AZMDAddiction (Substance Use Disorder) Counselor
423LAMDAddiction (Substance Use Disorder) Counselor
9400LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Pi LLC CurrentSince Jan 21, 2024 Accepting new patients
Green Holistic Recovery, LLC Addiction (Substance Use Disorder) Past Accepting new patients

Locations

18434 N 99th Ave
Ste 8
Sun City, AZ 85373
Phone (423) 330-0010

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1245380666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 GENERAL MEYER AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701313529",
            "telephone_number": "504-361-6500",
            "fax_number": "504-361-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18434 N 99TH AVE STE 8",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853731672",
            "telephone_number": "623-248-4104",
            "fax_number": "623-248-4943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ADA",
        "middle_name": "RUTH",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "423",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-155255",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "9400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.