Ted Whitney Allison, LISAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Sacaton, AZ
NPI 1508044223 · NPPES record last updated Feb 5, 2008
Key facts
- NPI
- 1508044223
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- LISAC-10852 (AZ)
- Practice address
- 483 Seed Farm Road
Sacaton, AZ 85247 - Phone
- (602) 528-7150
- Fax
- (602) 528-1374
- NPI assigned
- Feb 5, 2008
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LISAC-10852 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LISAC-10852 | AZ | Yes |
Addresses
Primary practice location
483 Seed Farm Road
Sacaton, AZ 85247
Mailing address
483 Seed Farm Road
Sacaton, AZ 85247
Phone (602) 528-7150
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 346214 | Medicaid | AZ |
Other providers in Sacaton, AZ
- Cynthia C Akason
- Dustin Akina
- Sheiba Ali
- Keith Allen
- Arlene S Allison
- Marlene D Allshouse
- Thomas Alan Alpert
- Anthony Vincent Anderson
- Ashley Anderson
- Frances Antone
All providers in Sacaton, AZ · Addiction (Substance Use Disorder) Counselor in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.