Individual provider Active NPI

Elisa Rodriguez, LPC

  • Professional Counselor
  • Mesa, AZ
National Provider Identifier
1376286948
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-22893 Issued in AZ
Practice address
2204 S Dobson Rd Ste 102
Mesa, AZ 85202-6457
Phone
(602) 230-7373
NPI assigned
Apr 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LAC-19489 AZ
Professional Counselor 101YP2500X LPC-22893 AZ Primary

Addresses

Primary practice location

2204 S Dobson Rd Ste 102
Mesa, AZ 85202-6457

Mailing address

3101 N Central Ave Ste 550
Phoenix, AZ 85012-2635
Phone (602) 230-7373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240419002016 AZ Practitioner - Mental Health Counselor 9638518863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Denova Collaborative Health, LLCGroup PAC ID 2466437736, 141 clinicians

Practice addresses (Care Compare)

235 W Western Ave
Avondale, AZ 85323-1848
Phone (602) 230-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LAC-19489AZMDCounselor
LPC-22893AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Denova Collaborative Health, LLC Current Accepting new patients
Denova Collaborative Health, LLC CurrentSince Apr 5, 2024 Accepting new patients

Locations

506 E Western Ave
Ste 104
Avondale, AZ 85323

235 W Western Ave
Avondale, AZ 85323
Phone (623) 772-5091

2120 W Guadalupe Rd
Ste 6
Mesa, AZ 85202
Phone (480) 629-8577

2204 S Dobson Rd
Ste 102
Mesa, AZ 85202

610 E Baseline Rd
Ste 5
Phoenix, AZ 85042

9014 S Central Ave
Phoenix, AZ 85042
Phone (602) 384-8820

3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289

3101 N Central Ave
Ste 500
Phoenix, AZ 85012

3620 N 3rd St
Phoenix, AZ 85012
Phone (602) 329-8250

3101 N Central Ave
Ste 550
Phoenix, AZ 85012

750 E Thunderbird Rd
Ste 13
Phoenix, AZ 85022
Phone (602) 682-7455

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1376286948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N CENTRAL AVE STE 550",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122635",
            "telephone_number": "602-230-7373",
            "fax_number": "602-682-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 S DOBSON RD STE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026457",
            "telephone_number": "602-230-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ELISA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LAC-19489",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-22893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.