Active NPI
Darcy Dudleston Bracamonte, LIAC, LPC
- Mental Health Counselor
- Glendale, AZ
National Provider Identifier
1902264773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC-24561
- Practice address
- 17505 N. 79TH Ave
302A
Glendale, AZ 85308 - Phone
- (623) 850-5404
- NPI assigned
- Feb 8, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC-24561 | AZ | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LIAC-11520 | AZ |
Addresses
Primary practice location
17505 N. 79TH Ave
302A
Glendale, AZ 85308
Mailing address
17505 N 79TH Ave Ste 311F
Glendale, AZ 85308-8730
Phone (623) 850-5404
Other names 1
- Mrs. Darcy Bracamonte
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
| License | State | Type | Specialty |
|---|---|---|---|
| LIAC-11520 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
| LPC-24561 | AZ | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agape Counseling Services | Mental Health | Current | Accepting new patients |
Locations
17505 N 79th Ave
Ste 311F
Glendale, AZ 85308
Phone (602) 674-0257
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Glendale, AZ
- NPI 1366389579
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774310400000",
"number": "1902264773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17505 N 79TH AVE STE 311F",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853088730",
"telephone_number": "623-850-5404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17505 N. 79TH AVE",
"address_2": "302A",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "85308",
"telephone_number": "623-850-5404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDLESTON BRACAMONTE",
"first_name": "DARCY",
"name_prefix": "Mrs.",
"credential": "LIAC, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-08",
"last_updated": "2026-03-24",
"certification_date": "2026-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "LPC-24561",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AZ",
"license": "LIAC-11520",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DARCY",
"last_name": "BRACAMONTE",
"prefix": "MRS.",
"credential": "LIAC, LPC",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.