Individual provider Active NPI

Angela Bassett

  • Addiction (Substance Use Disorder) Counselor
  • Cottonwood, AZ
National Provider Identifier
1265015143
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LISAC15212 Issued in AZ
Practice address
8 E Cottonwood St
Cottonwood, AZ 86326-4382
Phone
(877) 634-7333
Fax
(928) 634-8960
NPI assigned
Apr 29, 2021
Last updated
Apr 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LISAC15212 AZ Primary

Addresses

Primary practice location

8 E Cottonwood St
Cottonwood, AZ 86326-4382

Mailing address

8 E Cottonwood St
Cottonwood, AZ 86326-4382
Phone (877) 634-7333

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
LISAC15212AZMDAddiction (Substance Use Disorder) Counselor

Interoperability endpoints

  • Direct secure messaging: angela.bassett.p1@direct.spectrumhg.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1265015143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 E COTTONWOOD ST",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264382",
            "telephone_number": "877-634-7333",
            "fax_number": "928-634-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 E COTTONWOOD ST",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264382",
            "telephone_number": "877-634-7333",
            "fax_number": "928-634-8960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSETT",
        "first_name": "ANGELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC15212",
            "primary": true
        }
    ],
    "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 Apr 29, 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.