Active NPI
Lisa Yazzie, LAC
- Addiction (Substance Use Disorder) Counselor
- Tucson, AZ
National Provider Identifier
1366004764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1811
- Practice address
- 6802 E Broadway Blvd
Tucson, AZ 85710-2809 - Phone
- (520) 314-5180
- NPI assigned
- Jul 5, 2019
- 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 | 1811 | ND | Primary |
Addresses
Primary practice location
6802 E Broadway Blvd
Tucson, AZ 85710-2809
Mailing address
10195 E Desert Skyline Way
Tucson, AZ 85747-5143
Phone (559) 707-9550
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 |
|---|---|---|---|
| 1811 | ND | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562284800000",
"number": "1366004764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10195 E DESERT SKYLINE WAY",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857475143",
"telephone_number": "559-707-9550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6802 E BROADWAY BLVD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857102809",
"telephone_number": "520-314-5180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAZZIE",
"first_name": "LISA",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-05",
"last_updated": "2019-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "ND",
"license": "1811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.