Mark D Mansfield, MC, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-20544 Issued in AZ

Practice address

15820 N 35TH Ave Ste 14
Phoenix, AZ 85053-7608

Phone

(602) 859-9169

NPI assigned

Nov 12, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mind and Soul Counseling Services LLCGroup PAC ID 4486094083, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Mind & Soul Counseling Services LLC

  • Mental Health Counselor
  • Mesa, AZ
  • NPI 1962095927
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1952879520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5139 E TANO ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444120",
            "telephone_number": "480-241-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15820 N 35TH AVE STE 14",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850537608",
            "telephone_number": "602-859-9169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3303 E Baseline Rd Ste 109",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852342739",
            "country_code": "US",
            "telephone_number": "480-278-5290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSFIELD",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "MC, LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-12",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-20544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ BOARD OF BEHAVIORAL HEALTH",
            "identifier": "LPC-20544",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Manriquez
• Maria Manriquez, MD
• Jacqueline Mansaram
• Abdul Karim Mansaray
• Pascal Dominique Mansell
• Shayna M Mansfield, D.O.
• Prabhleen Kaur Manshahia, M.D.
• Lesley M Manson, PSY-D
• John Mansoor, PSYD
• Nayla Mansoor, PA-C

• Mental Health Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.