Individual provider Active NPI

Adia Visolela Plourd, PSYD, LAC

  • Mental Health Counselor
  • Glendale, AZ
National Provider Identifier
1659003010
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LAC-20991 Issued in AZ
Practice address
7155 W Campo Bello Dr Ste B110
Glendale, AZ 85308-8594
Phone
(623) 218-6030
Fax
(623) 218-6230
NPI assigned
Jun 25, 2022
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LAC-20991 AZ Primary
Counseling Psychologist 103TC1900X

Addresses

Primary practice location

7155 W Campo Bello Dr Ste B110
Glendale, AZ 85308-8594

Mailing address

318 S 116TH Ave
Avondale, AZ 85323-1780
Phone (602) 391-6527

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
I20251006002346 AZ Practitioner - Mental Health Counselor 1759887946 Practice locations: Peoria, AZ

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

318 S 116TH Ave
Avondale, AZ 85323-1780

9401 W Thunderbird Rd
Suite 187
Peoria, AZ 85381-4210
Phone (602) 935-4084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LAC-20991AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Through Connection CurrentSince Feb 4, 2024 Accepting new patients
Transformative Counseling and Trauma Healing Services, LLC Mental Health CurrentSince Feb 11, 2024 Accepting new patients

Locations

7155 W Campo Bello Dr
Ste B110
Glendale, AZ 85308
Phone (623) 218-6030

9401 W Thunderbird Rd
Ste 187
Peoria, AZ 85381
Phone (602) 473-8284

Organizations & group practices 2

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": "1656115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1659003010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 S 116TH AVE",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853231780",
            "telephone_number": "602-391-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7155 W CAMPO BELLO DR STE B110",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088594",
            "telephone_number": "623-218-6030",
            "fax_number": "623-218-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOURD",
        "first_name": "ADIA",
        "middle_name": "VISOLELA",
        "name_prefix": "Dr.",
        "credential": "PSYD, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-25",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-20991",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.