NPIMap

Organization Active NPI

Bella Vista Resources

  • Clinical Social Worker
  • Mesa, AZ
National Provider Identifier
1780979583
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 12033 Issued in AZ
Legal business name
BELLA VISTA RESOURCES
Practice address
5911 E Nance St
Mesa, AZ 85215-1485
Phone
(480) 305-3160
NPI assigned
Jun 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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

Authorized official

Name
Diana Marie Kyrisch, LCSWNPI 1760545545
Title
President
Phone
(480) 305-3160

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X LCSW 12033 AZ Primary

Addresses

Primary practice location

5911 E Nance St
Mesa, AZ 85215-1485

Mailing address

PO Box 22243
Mesa, AZ 85277-2243
Phone (480) 305-3160

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307577600000",
    "number": "1780979583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22243",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852772243",
            "telephone_number": "480-305-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 E NANCE ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151485",
            "telephone_number": "480-305-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLA VISTA RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-09",
        "last_updated": "2011-06-09",
        "status": "A",
        "authorized_official_last_name": "KYRISCH",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-305-3160",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW 12033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; 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.