Individual provider Active NPI

Rachelle Burrup, ACMHC

  • Mental Health Counselor
  • Scottsdale, AZ
National Provider Identifier
1396453072
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12998252-6009 Issued in UT
Practice address
6125 E Indian School Rd Ste 1005
Scottsdale, AZ 85251-5469
Phone
(480) 877-9284
NPI assigned
Nov 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 12998252-6009 UT Primary

Addresses

Primary practice location

6125 E Indian School Rd Ste 1005
Scottsdale, AZ 85251-5469

Mailing address

6125 E Indian School Rd Ste 1005
Scottsdale, AZ 85251-5469
Phone (480) 877-9284

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
12998252-6009UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Evolvedmd, Inc. CurrentSince May 28, 2023 Accepting new patients

Locations

6125 E Indian School Rd
Ste 1005
Scottsdale, AZ 85251
Phone (480) 542-0123

Organizations & group practices 1

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": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1396453072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6125 E INDIAN SCHOOL RD STE 1005",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852515469",
            "telephone_number": "480-877-9284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6125 E INDIAN SCHOOL RD STE 1005",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852515469",
            "telephone_number": "480-877-9284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRUP",
        "first_name": "RACHELLE",
        "credential": "ACMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "12998252-6009",
            "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 Nov 10, 2022; 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.