Individual provider Active NPI

Debra Marie Laurie, MSW, LISAC

  • Addiction (Substance Use Disorder) Counselor
  • Phoenix, AZ
National Provider Identifier
1821333832
Registry record updated Dec 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LISAC-1673 Issued in AZ
Practice address
5062 N 19TH Ave
Suite # 102
Phoenix, AZ 85015-3225
Phone
(623) 939-6567
Fax
(623) 939-7365
NPI assigned
Dec 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2012

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 LISAC-1673 AZ Primary

Addresses

Primary practice location

5062 N 19TH Ave
Suite # 102
Phoenix, AZ 85015-3225

Mailing address

5062 N 19TH Ave
Suite # 102
Phoenix, AZ 85015-3225
Phone (623) 939-6567

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

LicenseStateTypeSpecialty
LISAC-1673AZMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1354406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354406400000",
    "number": "1821333832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5062 N 19TH AVE",
            "address_2": "SUITE # 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850153225",
            "telephone_number": "623-939-6567",
            "fax_number": "623-939-7365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5062 N 19TH AVE",
            "address_2": "SUITE # 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850153225",
            "telephone_number": "623-939-6567",
            "fax_number": "623-939-7365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURIE",
        "first_name": "DEBRA",
        "middle_name": "MARIE",
        "credential": "MSW, LISAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-02",
        "last_updated": "2012-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-1673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2012; 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.