Active NPI
Geovana Colosio, LISAC
- Addiction (Substance Use Disorder) Counselor
- Yuma, AZ
National Provider Identifier
1740487594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LISAC-11460
- Practice address
- 1020 S 4TH Ave
Suite C
Yuma, AZ 85364-3859 - Phone
- (928) 343-9825
- NPI assigned
- Jun 27, 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 | LISAC-11460 | AZ | Primary |
Addresses
Primary practice location
1020 S 4TH Ave
Suite C
Yuma, AZ 85364-3859
Mailing address
1842 S 17TH Ave
Yuma, AZ 85364-5354
Phone (928) 782-6455
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 |
|---|---|---|---|
| LISAC-11460 | 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": "1182902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740487594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1842 S 17TH AVE",
"city": "YUMA",
"state": "AZ",
"postal_code": "853645354",
"telephone_number": "928-782-6455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 S 4TH AVE",
"address_2": "SUITE C",
"city": "YUMA",
"state": "AZ",
"postal_code": "853643859",
"telephone_number": "928-343-9825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLOSIO",
"first_name": "GEOVANA",
"name_prefix": "Mrs.",
"credential": "LISAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AZ",
"license": "LISAC-11460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yuma, 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.