Active NPI
Louise Egan
- Addiction (Substance Use Disorder) Counselor
- Phoenix, AZ
National Provider Identifier
1336566124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LISAC - 10073
- Practice address
- 4220 N 20TH Ave
100
Phoenix, AZ 85015-5101 - Phone
- (602) 254-9701
- Fax
- (602) 252-0830
- NPI assigned
- Mar 18, 2014
- Last updated
- Mar 18, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LISAC - 10073 | AZ | Primary |
Addresses
Primary practice location
4220 N 20TH Ave
100
Phoenix, AZ 85015-5101
Mailing address
4220 N 20TH Ave
100
Phoenix, AZ 85015-5101
Phone (602) 254-9701
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
| License | State | Type | Specialty |
|---|---|---|---|
| LISAC - 10073 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395100800000",
"number": "1336566124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4220 N 20TH AVE",
"address_2": "100",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850155101",
"telephone_number": "602-254-9701",
"fax_number": "602-252-0830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4220 N 20TH AVE",
"address_2": "100",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850155101",
"telephone_number": "602-254-9701",
"fax_number": "602-252-0830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGAN",
"first_name": "LOUISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-18",
"last_updated": "2014-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AZ",
"license": "LISAC - 10073",
"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 Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.