Annette B. Church, LPC, LISAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LISAC-10423 Issued in AZ

Practice address

642 Dameron Dr
Prescott, AZ 86301-2411

Phone

(928) 445-5211

Fax

(928) 776-0963

NPI assigned

Jun 2, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1952349011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 DAMERON DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012411",
            "telephone_number": "928-445-5211",
            "fax_number": "928-776-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 DAMERON DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012411",
            "telephone_number": "928-445-5211",
            "fax_number": "928-776-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "ANNETTE",
        "middle_name": "B.",
        "name_prefix": "Ms.",
        "credential": "LPC, LISAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-10423",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-10149",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS #",
            "identifier": "590027",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chiropractic Fitness Center
• Malgorzata Chmura-Witusik, RN
• Brett James Christensen, OD
• Eric Clayton Christensen, M.D.
• Gbemisola Yemisi Chukwu, PMHNP
• Adryanna B Ciera, LMT
• Richard Allen Cirelli, M.D
• Clarity Lab LLC
• John Clarizio, LMSW
• Jessica Lee Clark, PT, DPT

• Addiction (Substance Use Disorder) Counselor in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Addiction (Substance Use Disorder) Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.