Individual provider Active NPI

Nanci D Gainsforth, LISAC

  • Addiction (Substance Use Disorder) Counselor
  • Phoenix, AZ
National Provider Identifier
1710112628
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LISAC-10593 Issued in AZ
Practice address
1415 N 1St St
Phoenix, AZ 85004-1604
Phone
(602) 685-6000
Fax
(602) 685-6001
NPI assigned
May 20, 2009
Last updated
May 20, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LISAC-10593 AZ Primary

Addresses

Primary practice location

1415 N 1St St
Phoenix, AZ 85004-1604

Mailing address

3003 N Central Ave
Suite 200
Phoenix, AZ 85012-2902
Phone (602) 685-6000

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

LicenseStateTypeSpecialty
LISAC-10593AZMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242777600000",
    "number": "1710112628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122902",
            "telephone_number": "602-685-6000",
            "fax_number": "602-685-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 N 1ST ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041604",
            "telephone_number": "602-685-6000",
            "fax_number": "602-685-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINSFORTH",
        "first_name": "NANCI",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "LISAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-20",
        "last_updated": "2009-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-10593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.