Brent E Case
Individual provider Active NPI Professional Counselor · Page, AZ
NPI 1952330656 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1952330656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC-12277 (AZ)
- Practice address
- 463 S. Lake Powell Blvd
Page, AZ 86040-0790 - Phone
- (928) 645-5113
- Fax
- (928) 645-3254
- NPI assigned
- Jul 3, 2006
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-12277 | AZ | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-12277 | AZ | Yes |
Addresses
Primary practice location
463 S. Lake Powell Blvd
Page, AZ 86040-0790
Mailing address
463 S. Lake Powell Blvd
PO Box 790
Page, AZ 86040-0790
Phone (928) 645-5113
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101918 | Medicaid | AZ |
Other providers in Page, AZ
- Canyonlands Community Health Care
- Canyonlands Community Health Care
- Canyonlands Community Healthcare - BH
- Care for You, PC
- Ryan Matthew Carr
- Pamela Juliet Chambers
- Ralph L Chester
- Ryan Kerry Chin
- Ronald L Christ
- City of Page
All providers in Page, AZ · Professional Counselor in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.