Individual provider Active NPI

Linsey M Mettenbrink, LPC

  • Professional Counselor
  • Mesa, AZ
National Provider Identifier
1467050195
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
19258 Issued in AZ
Practice address
1111 S Stapley Dr
Mesa, AZ 85204-5059
Phone
(602) 685-6000
Fax
(480) 834-5703
NPI assigned
Oct 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 19258 AZ Primary

Addresses

Primary practice location

1111 S Stapley Dr
Mesa, AZ 85204-5059

Mailing address

3003 N Central Ave Ste 400
Phoenix, AZ 85012-2929
Phone (602) 685-6000

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
I20240116004179 AZ Practitioner - Mental Health Counselor 2961854872 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19258AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Terros Inc CurrentSince Jan 1, 2024 Accepting new patients
Terros, Inc CurrentSince Jan 1, 2024 Accepting new patients
Terros, Inc. Current Accepting new patients

Locations

1111 S Stapley Dr
Mesa, AZ 85204
Phone (480) 464-6802

4909 E McDowell Rd
Phoenix, AZ 85008
Phone (602) 244-9591

3003 N Central Ave
Ste 400
Phoenix, AZ 85012
Phone (602) 351-3015

Organizations & group practices 3

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": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1467050195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122929",
            "telephone_number": "602-685-6000",
            "fax_number": "602-302-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S STAPLEY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045059",
            "telephone_number": "602-685-6000",
            "fax_number": "480-834-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METTENBRINK",
        "first_name": "LINSEY",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "19258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.