Jolene Bristow, RN, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC 12398 Issued in AZ

Practice address

701 N. la Canada Drive
Suite 90
Green Valley, AZ 85614

Phone

(520) 625-3835

Fax

(520) 625-5585

NPI assigned

Oct 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1316029952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 W PINON DR",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856144332",
            "telephone_number": "520-370-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N. LA CANADA DRIVE",
            "address_2": "SUITE 90",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "85614",
            "telephone_number": "520-625-3835",
            "fax_number": "520-625-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTOW",
        "first_name": "JOLENE",
        "credential": "RN, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC 12398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arlo B Brakel, M.D.
• Joy Brashear, RPH
• Kathryn G. Breese, D.C.
• Robert Andrew Brick, MD
• Bright Sight Optometry PLLC
• Christopher Cade Broderick, D.C
• Laura S Brown, MD
• Martin L Brown, MD
• Amber D. Brumfield, HAD
• Bryan T McConnell DO PLC

• Mental Health Counselor in Green Valley, AZ
• Providers in Green Valley, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.