Active NPI
Kathleen Trinette Costello
- Professional Counselor
- Scottsdale, AZ
National Provider Identifier
1619614625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-19879
- Practice address
- 8700 E Vista Bonita Dr Ste 188
Scottsdale, AZ 85255-3205 - Phone
- (480) 506-9747
- NPI assigned
- May 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC19879 | AZ | |
| Professional Counselor | 101YP2500X | LPC-19879 | AZ | Primary |
Addresses
Primary practice location
8700 E Vista Bonita Dr Ste 188
Scottsdale, AZ 85255-3205
Mailing address
13527 E Summit Dr
Scottsdale, AZ 85259-2222
Phone (719) 439-0250
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
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-19879 | AZ | MD | Professional Counselor |
| LPC19879 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698019200000",
"number": "1619614625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13527 E SUMMIT DR",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852592222",
"telephone_number": "719-439-0250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8700 E VISTA BONITA DR STE 188",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852553205",
"telephone_number": "480-506-9747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTELLO",
"first_name": "KATHLEEN",
"middle_name": "TRINETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-19",
"last_updated": "2023-10-23",
"certification_date": "2023-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC19879",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-19879",
"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 Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.