Individual provider Active NPI

Holly Brown-Sisson, LPC

  • Professional Counselor
  • Tucson, AZ
National Provider Identifier
1609036508
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
13016 Issued in AZ
Practice address
5049 E Broadway Blvd
Suite 108
Tucson, AZ 85711-3645
Phone
(520) 748-2300
Fax
(520) 748-2355
NPI assigned
Jun 13, 2008
Last updated
Jun 13, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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 13016 AZ Primary

Addresses

Primary practice location

5049 E Broadway Blvd
Suite 108
Tucson, AZ 85711-3645

Mailing address

5049 E Broadway Blvd
Suite 108
Tucson, AZ 85711-3645
Phone (520) 748-2300

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
I20241206000748 AZ Practitioner - Mental Health Counselor 9436203122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renewal Centers IncGroup PAC ID 0143356139, 3 clinicians

Practice addresses (Care Compare)

7445 N Oracle Rd
Suite 155
Tucson, AZ 85704-6367
Phone (888) 592-1904

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13016AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Renewal Centers Inc CurrentSince Dec 1, 2024 Accepting new patients

Locations

555 S La Canada Dr
Green Valley, AZ 85614
Phone (520) 791-9974

6390 E Broadway Blvd
Ste 210
Tucson, AZ 85710
Phone (520) 791-9974

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1609036508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5049 E BROADWAY BLVD",
            "address_2": "SUITE 108",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113645",
            "telephone_number": "520-748-2300",
            "fax_number": "520-748-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5049 E BROADWAY BLVD",
            "address_2": "SUITE 108",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113645",
            "telephone_number": "520-748-2300",
            "fax_number": "520-748-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN-SISSON",
        "first_name": "HOLLY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-13",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "13016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.