Active NPI
Nanette Darlene Mongelluzzo, LPC
- Professional Counselor
- Sedona, AZ
National Provider Identifier
1962617936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 11867
- Practice address
- 155 Cathedral Rock Dr
Sedona, AZ 86351-8640 - Phone
- (928) 284-0774
- NPI assigned
- May 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 11867 | AZ | Primary |
Addresses
Primary practice location
155 Cathedral Rock Dr
Sedona, AZ 86351-8640
Mailing address
155 Cathedral Rock Dr
Sedona, AZ 86351-8640
Phone (928) 284-0774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jun 29, 2024 through Jun 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11867 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962617936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 CATHEDRAL ROCK DR",
"city": "SEDONA",
"state": "AZ",
"postal_code": "863518640",
"telephone_number": "928-284-0774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 CATHEDRAL ROCK DR",
"city": "SEDONA",
"state": "AZ",
"postal_code": "863518640",
"telephone_number": "928-284-0774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONGELLUZZO",
"first_name": "NANETTE",
"middle_name": "DARLENE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "11867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sedona, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.