Active NPI
Daniel Bejar, LISAC
- Addiction (Substance Use Disorder) Counselor
- Prescott Valley, AZ
National Provider Identifier
1629256433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LISAC-1083
- Practice address
- 8200 E Jacque Dr
Prescott Valley, AZ 86314-6172 - Phone
- (928) 713-6328
- NPI assigned
- Feb 4, 2008
- Last updated
- Jan 11, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LISAC-1083 | AZ | Primary |
Addresses
Primary practice location
8200 E Jacque Dr
Prescott Valley, AZ 86314-6172
Mailing address
8200 E Jacque Dr
Prescott Valley, AZ 86314-6172
Phone (928) 713-6328
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 854580 | Medicaid | AZ |
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 |
|---|---|---|---|
| LISAC-1083 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nazcare, Inc. - Eaton Center for Joyful Health | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Eaton Center for Joyful Health
- Mental Health Counselor
- Prescott Valley, AZ
- NPI 1528415650
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484092800000",
"number": "1629256433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8200 E JACQUE DR",
"city": "PRESCOTT VALLEY",
"state": "AZ",
"postal_code": "863146172",
"telephone_number": "928-713-6328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8200 E JACQUE DR",
"city": "PRESCOTT VALLEY",
"state": "AZ",
"postal_code": "863146172",
"telephone_number": "928-713-6328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEJAR",
"first_name": "DANIEL",
"name_prefix": "Mr.",
"credential": "LISAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-04",
"last_updated": "2017-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AZ",
"license": "LISAC-1083",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "854580",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Prescott Valley, AZ
- Beeson Chiropractic Life Center Inc (Beeson Chiropractic Center)
- Lynne Marie Beeson Coit, LMT
- Alan L Beeson, D.C., CCSP
- Kathy J Beeson, D.C.
- Beginnings Birth and Wellness Center
- Patricia Louise Benard-Walls, ARNP
- Bennett Clinic LLC (Bennett Clinic)
- Bennett Clinic LLC
- Reneallia Bennett, NP
- Maridol Macias Bercilla, LVN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.