Brianda I. Teterukov, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-20112 Issued in AZ

Practice address

21436 N 20TH Ave
Phoenix, AZ 85027-2612

Phone

(602) 888-1107

NPI assigned

Sep 24, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Az Therapy Quest LLC

  • Professional Counselor
  • Phoenix, AZ
  • NPI 1457137721
  NPD Authorized official

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1245901644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21681 N 61ST AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086316",
            "telephone_number": "520-313-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21436 N 20TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850272612",
            "telephone_number": "602-888-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETERUKOV",
        "first_name": "BRIANDA",
        "middle_name": "I.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-24",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-20112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brianda@animuscounseling.com",
            "affiliation": "N",
            "endpointDescription": "business email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21436 N 20th Ave",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850272612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Carmine Testa, M.D.
• Erin Testa, PH.D.
• Testimony Behavioral Health Residential LLC
• Testlabs
• Kelly Teter
• Joyce J Tetreault, FNP
• Debbie Marie Tew, OTR/L, CLT-LANA
• Elease Kathryn Tewalt
• Isheeta Tewari, MD
• Alex Belai Tewoldemedhin, ATS

• Professional Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; 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.