Individual provider Active NPI

Deborah L McClish, LSAT, LISAC

  • Addiction (Substance Use Disorder) Counselor
  • Casa Grande, AZ
National Provider Identifier
1356793608
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
15098 Issued in AZ
Practice address
1901 N Trekell Rd
Casa Grande, AZ 85122-1770
Phone
(520) 836-1029
Fax
(520) 836-6733
NPI assigned
Jul 11, 2016
Last updated
Jul 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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 15098 AZ Primary

Addresses

Primary practice location

1901 N Trekell Rd
Casa Grande, AZ 85122-1770

Mailing address

1901 N Trekell Rd
Casa Grande, AZ 85122-1770
Phone (520) 836-1029

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
15098AZMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1356793608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 N TREKELL RD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851221770",
            "telephone_number": "520-836-1029",
            "fax_number": "520-836-6733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 N TREKELL RD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851221770",
            "telephone_number": "520-836-1029",
            "fax_number": "520-836-6733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLISH",
        "first_name": "DEBORAH",
        "middle_name": "L",
        "credential": "LSAT, LISAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "15098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; 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.