Individual provider Active NPI

Darcy Dudleston Bracamonte, LIAC, LPC

  • Mental Health Counselor
  • Glendale, AZ
National Provider Identifier
1902264773
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC-24561 Issued in AZ
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

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 Other name

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
LIAC-11520AZMDAddiction (Substance Use Disorder) Counselor
LPC-24561AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.