Individual provider Active NPI

Donn Yeager, LISAC

  • Addiction (Substance Use Disorder) Counselor
  • Phoenix, AZ
National Provider Identifier
1427414531
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LASAC-15155 Issued in AZ
Practice address
1017 W Vista Ave
Phoenix, AZ 85021-8064
Phone
(602) 400-4445
NPI assigned
Jan 5, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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 LASAC-15155 AZ Primary

Addresses

Primary practice location

1017 W Vista Ave
Phoenix, AZ 85021-8064

Mailing address

1017 W Vista Ave
Phoenix, AZ 85021-8064
Phone (602) 400-4445

Other practice location 1

919 12th Pl Ste 13
Prescott, AZ 86305-1433
Phone (928) 227-2967

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
I20240103002080 AZ Practitioner - Mental Health Counselor 4183074149 Practice locations: Phoenix, AZ

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Phoenix, AZ 85021
Phone (602) 400-4445

20715 Timberlake Rd
Suite 102
Lynchburg, VA 24502-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LASAC-15155AZMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Semper Fi Counseling Services, LLC Addiction (Substance Use Disorder) CurrentSince Sep 15, 2021 Accepting new patients

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": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1427414531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 W VISTA AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850218064",
            "telephone_number": "602-400-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 W VISTA AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850218064",
            "telephone_number": "602-400-4445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "919 12th Pl Ste 13",
            "address_purpose": "LOCATION",
            "city": "Prescott",
            "state": "AZ",
            "postal_code": "863051433",
            "country_code": "US",
            "telephone_number": "928-227-2967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEAGER",
        "first_name": "DONN",
        "credential": "LISAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-05",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LASAC-15155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.