Organization Active NPI

Copper Leaf Counseling LLC

  • Clinical Social Worker
  • Mesa, AZ
National Provider Identifier
1871607689
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 2409 Issued in AZ
Legal business name
COPPER LEAF COUNSELING LLC
Practice address
6344 E Broadway Rd
Suite 104
Mesa, AZ 85206-1634
Phone
(480) 703-7950
Fax
(480) 218-1895
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Lisa Marie Edin Browning, MSW, LCSWNPI 1063494318
Title
Member/Manager
Phone
(480) 703-7950

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: 193400000X SINGLE SPECIALTY GROUP 1041C0700X LCSW 2409 AZ Primary

Addresses

Primary practice location

6344 E Broadway Rd
Suite 104
Mesa, AZ 85206-1634

Mailing address

6344 E Broadway Rd
Suite 104
Mesa, AZ 85206-1634
Phone (480) 703-7950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070131000017 AZ Part B Supplier - Clinic/Group Practice 2567463714 Receives reassigned benefits from 1 practitioner
Practice locations: Red Rock, AZ

National Provider Directory

National Provider Directory

Locations

6344 E Broadway Rd
Ste 104
Mesa, AZ 85206
Phone (480) 703-1894

6239 E Brown Rd
Ste 115
Mesa, AZ 85205
Phone (480) 703-7950

Practitioners & affiliated clinicians

Practitioners 2

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": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1871607689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6344 E BROADWAY RD",
            "address_2": "SUITE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061634",
            "telephone_number": "480-703-7950",
            "fax_number": "480-218-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6344 E BROADWAY RD",
            "address_2": "SUITE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061634",
            "telephone_number": "480-703-7950",
            "fax_number": "480-218-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER LEAF COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "BROWNING",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE EDIN",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "480-703-7950",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW 2409",
            "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 Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.