Individual provider Active NPI

Bryan Acosta, MS, LIAC

  • Addiction (Substance Use Disorder) Counselor
  • Laveen, AZ
National Provider Identifier
1811809726
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LIAC-155408 Issued in AZ
Practice address
17242 S Healthcare Dr
Laveen, AZ 85339-8501
Phone
(520) 796-3815
NPI assigned
Sep 17, 2026
Last updated
Sep 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LIAC-155408 AZ Primary

Addresses

Primary practice location

17242 S Healthcare Dr
Laveen, AZ 85339-8501

Mailing address

11367 W Overlin Dr
Avondale, AZ 85323-1131
Phone (602) 465-9831

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

NPI Registry JSON

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

{
    "created_epoch": "1789603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1811809726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11367 W OVERLIN DR",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853231131",
            "telephone_number": "602-465-9831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17242 S HEALTHCARE DR",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853398501",
            "telephone_number": "520-796-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "BRYAN",
        "credential": "MS, LIAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-17",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LIAC-155408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laveen, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; 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.