Clairissa M. O'Dea, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LAC-20665 Issued in AZ

Practice address

300 W Clarendon Ave Ste 470
Phoenix, AZ 85013-3475

Phone

(602) 730-4450

Fax

(602) 391-2522

NPI assigned

Jul 9, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 14, 2024 through Nov 14, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sentience Psycological Services PLLC

  • Psychologist
  • Phoenix, AZ
  • NPI 1487999371
  NPD
• Sentience, PLLC

  • Counseling Psychologist
  • Phoenix, AZ
  • NPI 1144730086
  NPD (past)

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1710242532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE STE 470",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133475",
            "telephone_number": "847-863-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE STE 470",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133475",
            "telephone_number": "602-730-4450",
            "fax_number": "602-391-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DEA",
        "first_name": "CLAIRISSA",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.006898",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-20665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayrn D O'Connor, M.D.
• Brendan Patrick O'Connor, DC
• Martha Susan O'Connor, O.T.
• Peter O'Connor, M.D.
• Suzanne O'Connor, PSYD
• Suzanne Marie O'Dea, MA, NCSP
• Shelley Denise O'Dell-Brock, DAC
• Anne Terese O'Donnell, MA, BCBA, LBA
• Brandon O'Donnell, LMSW
• Breana O'Donnell, LPN

• Mental Health Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.