John Michael Allen, LPC-00279

Individual provider Active NPI Counselor · Prescott, AZ

NPI 1861670937 · NPPES record last updated Feb 12, 2008

Key facts

NPI
1861670937
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
License
LPC 00279 (AZ)
Practice address
375 W Tamarack LN
Prescott, AZ 86301-1250
Phone
(928) 830-9692
NPI assigned
Jan 31, 2008
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPC 00279AZMDCounselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC 00279 AZ Yes

Addresses

Primary practice location

375 W Tamarack LN
Prescott, AZ 86301-1250

Mailing address

375 W Tamarack LN
Prescott, AZ 86301-1250
Phone (928) 830-9692

Other providers in Prescott, AZ

All providers in Prescott, AZ · Counselor in Arizona

Sources for this page

Verify at the official NPI Registry.