Individual provider Active NPI

Neal Reiersen, LPC

  • Professional Counselor
  • Phoenix, AZ
National Provider Identifier
1740744135
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-17485 Issued in AZ
Practice address
3118 W Thomas Rd Ste 712
Phoenix, AZ 85017-5308
Phone
(602) 388-4017
NPI assigned
Jan 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-17485 AZ Primary

Addresses

Primary practice location

3118 W Thomas Rd Ste 712
Phoenix, AZ 85017-5308

Mailing address

3118 W Thomas Rd Ste 712
Phoenix, AZ 85017-5308
Phone (602) 388-4017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240220002052 AZ Practitioner - Mental Health Counselor 9931543774 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-17485AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Professional CurrentSince Feb 7, 2024 Accepting new patients
Dos Abuelos Arizona, LLC PastSince Aug 19, 2017 Accepting new patients
Dos Abuelos Arizona LLC Past Accepting new patients

Locations

20 E Thomas Rd
Ste 2200
Phoenix, AZ 85012
Phone (310) 515-8113

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1740744135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3118 W THOMAS RD STE 712",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850175308",
            "telephone_number": "602-388-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3118 W THOMAS RD STE 712",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850175308",
            "telephone_number": "602-388-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIERSEN",
        "first_name": "NEAL",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-17485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.