Active NPI
Elaine Roan, LISAC
- Addiction (Substance Use Disorder) Counselor
- Tuba City, AZ
National Provider Identifier
1659587814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 11593
- Practice address
- 160 North Main Street
Building 25
Tuba City, AZ 86045 - Phone
- (928) 283-3046
- Fax
- (928) 283-3039
- NPI assigned
- May 15, 2007
- Sex
- Female
- 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 | 11593 | AZ | Primary |
Addresses
Primary practice location
160 North Main Street
Building 25
Tuba City, AZ 86045
Mailing address
PO Box 2155
Tuba City, AZ 86045-2155
Phone (928) 283-3346
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 |
|---|---|---|---|
| 11593 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659587814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2155",
"city": "TUBA CITY",
"state": "AZ",
"postal_code": "860452155",
"telephone_number": "928-283-3346",
"fax_number": "928-283-3039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 NORTH MAIN STREET",
"address_2": "BUILDING 25",
"city": "TUBA CITY",
"state": "AZ",
"postal_code": "86045",
"telephone_number": "928-283-3046",
"fax_number": "928-283-3039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROAN",
"first_name": "ELAINE",
"name_prefix": "Ms.",
"credential": "LISAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AZ",
"license": "11593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tuba City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.