Active NPI
Carol Preuitt, LISAC
- Addiction (Substance Use Disorder) Counselor
- Mesa, AZ
National Provider Identifier
1376780775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LISAC-10547
- Practice address
- 450 W 5TH PL
Mesa, AZ 85201-5619 - Phone
- (480) 962-7922
- Fax
- (480) 962-7944
- NPI assigned
- Jan 7, 2009
- 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-10547 | AZ | Primary |
Addresses
Primary practice location
450 W 5TH PL
Mesa, AZ 85201-5619
Mailing address
1811 S Alma School Rd
Ste 160
Mesa, AZ 85210-3001
Phone (480) 831-7566
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-10547 | 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": "1231286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231286400000",
"number": "1376780775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1811 S ALMA SCHOOL RD",
"address_2": "STE 160",
"city": "MESA",
"state": "AZ",
"postal_code": "852103001",
"telephone_number": "480-831-7566",
"fax_number": "480-962-7671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 W 5TH PL",
"city": "MESA",
"state": "AZ",
"postal_code": "852015619",
"telephone_number": "480-962-7922",
"fax_number": "480-962-7944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREUITT",
"first_name": "CAROL",
"credential": "LISAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-07",
"last_updated": "2009-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AZ",
"license": "LISAC-10547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.