Individual provider Active NPI

Eusebio Quezada, LIAC

  • Addiction (Substance Use Disorder) Counselor
  • Phoenix, AZ
National Provider Identifier
1295689610
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LIAC-11384 Issued in AZ
Practice address
15650 N Black Canyon Hwy Ste B121
Phoenix, AZ 85053-4064
Phone
(480) 649-3352
Fax
(480) 649-3358
NPI assigned
Feb 23, 2026
Last updated
Feb 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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 LIAC-11384 AZ Primary

Addresses

Primary practice location

15650 N Black Canyon Hwy Ste B121
Phoenix, AZ 85053-4064

Mailing address

8002 W Roma Ave
Phoenix, AZ 85033-2207

Other practice location 1

3336 N 32nd St Ste 120
Phoenix, AZ 85018-6241
Phone (480) 649-3352

Other practice location 2

3802 N 53rd Ave Ste 110
Phoenix, AZ 85031-3036
Phone (480) 649-3352

Other practice location 3

6610 N 47th Ave Ste 68
Glendale, AZ 85301-4163
Phone (480) 649-3352

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
LIAC-11384AZMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Counseling, Inc. PastSince Oct 22, 2023 Accepting new patients
Sage Counseling, Inc. PastSince Sep 17, 2023 Accepting new patients
Sage Counseling, Inc. PastSince Jul 16, 2023 Accepting new patients

Organizations & group practices 3

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": "1771804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1295689610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8002 W ROMA AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850332207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15650 N BLACK CANYON HWY STE B121",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850534064",
            "telephone_number": "480-649-3352",
            "fax_number": "480-649-3358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3336 N 32nd St Ste 120",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850186241",
            "country_code": "US",
            "telephone_number": "480-649-3352",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3802 N 53rd Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850313036",
            "country_code": "US",
            "telephone_number": "480-649-3352",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6610 N 47th Ave Ste 68",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853014163",
            "country_code": "US",
            "telephone_number": "480-649-3352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUEZADA",
        "first_name": "EUSEBIO",
        "credential": "LIAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-23",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LIAC-11384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; 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.