Active NPI
Susan Margaret Panos, M.ED, LPC
- Professional Counselor
- Scottsdale, AZ
National Provider Identifier
1336723782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 19774
- Practice address
- 1717 N 77TH St Ste 16
Scottsdale, AZ 85257-2261 - Phone
- (480) 242-6911
- NPI assigned
- May 11, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 19774 | AZ | Primary |
Addresses
Primary practice location
1717 N 77TH St Ste 16
Scottsdale, AZ 85257-2261
Mailing address
2323 N Central Ave Unit 2101
Phoenix, AZ 85004-1344
Phone (480) 242-6911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 19, 2024 through Jun 19, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19774 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620691200000",
"number": "1336723782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2323 N CENTRAL AVE UNIT 2101",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850041344",
"telephone_number": "480-242-6911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 N 77TH ST STE 16",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852572261",
"telephone_number": "480-242-6911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANOS",
"first_name": "SUSAN",
"middle_name": "MARGARET",
"credential": "M.ED, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-11",
"last_updated": "2021-05-11",
"certification_date": "2021-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "19774",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.