Randy Dannheim, LISAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LISAC-11479 Issued in AZ

Practice address

5116 E Thomas Rd
Phoenix, AZ 85018-7915

Phone

(602) 281-6574

Fax

(602) 281-6905

NPI assigned

Dec 18, 2013

Last updated

Dec 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1710308788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5116 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850187915",
            "telephone_number": "602-281-6574",
            "fax_number": "602-281-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5116 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850187915",
            "telephone_number": "602-281-6574",
            "fax_number": "602-281-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANNHEIM",
        "first_name": "RANDY",
        "credential": "LISAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-18",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-11479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shiloh Joy Danley, NP-C
• Jeffrey Carlyle Dann, MD
• Eugene G. Dannels, DPM
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• Paige Danner, DPM
• Daniel Patrick Dansdill, M.D.
• Dantal Dental Two Corporation (Dental Brothers of Phoenix)
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• Dantreel Pate (All Together Behavioral Health GRP)
• Vishnu Dantu

• Addiction (Substance Use Disorder) Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Addiction (Substance Use Disorder) Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.