MRS. DARCY DUDLESTON BRACAMONTE (NPI# 1902264773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902264773 |
Entity Type | Individual |
Full Name | MRS. DARCY DUDLESTON BRACAMONTE |
Other Name | MRS. DARCY BRACAMONTE |
Credential | LISAC |
Practice Address |
17505 N. 79th Ave 302a Glendale AZ 85308 |
Mailing Address |
17505 N 79th Ave 302a Glendale AZ 85308-8725 |
Practice Telephone | 6238505404 |
Mailing Telephone | 6238505404 |
Enumeration Date | 2016-02-08 |
Last Update Date | 2016-02-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LISAC-11520 | AZ | Behavioral Health & Social Service Providers |
N | 101YM0800X |
Counselor Specialization: Mental Health |
LAC-11168 | AZ | Behavioral Health & Social Service Providers |
Street Address |
17505 N. 79TH AVE 302A |
City | GLENDALE |
State | AZ |
Zip Code | 85308 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952722480 | Rebecca Andersen | Counselor | 17505 N. 79th Ave, Suite 111c, Glendale, AZ 85308 | 2013-12-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972102572 | Inspire Wellness and Pelvic Health | Clinic/Center | 5940 W Union Hills Dr Ste D280, Glendale, AZ 85308 | 2020-10-23 |
1669081709 | Michelle Yoakim | Student in an Organized Health Care Education/Training Program | 19555 N 59th Avenuue, Glendale, AZ 85308 | 2020-07-24 |
1033742291 | Kaitlyn Marie Shannon | Dietitian, Registered | 20325 North 51st Avenue, Building 9, Suite 166, Glendale, AZ 85308 | 2020-02-17 |
1295377687 | Serenity Preserved Counseling Pllc | Counselor | 21448 N. 75th Avenue Ste G, Glendale, AZ 85308 | 2019-10-17 |
1013567023 | Caitlyn Heredia | Student in an Organized Health Care Education/Training Program | 18330 N 79th Avenue, Apartment 1070, Glendale, AZ 85308 | 2019-09-12 |
1770141061 | Sydney Dangelo | Student in an Organized Health Care Education/Training Program | 7454 W Denaro Dr, Glendale, AZ 85308 | 2019-05-31 |
1023585742 | Center for Couples Therapy, Pllc | Counselor | 18205 N 51st Ave, Ste 113, Glendale, AZ 85308 | 2018-10-31 |
1831678341 | Ayat Mahdi Obeidi | Dentist | 19420 N 59th Ave Ste D400, Glendale, AZ 85308 | 2018-08-07 |
1720580038 | Lifeline Professional Counseling Services, Inc | Clinic/Center | 17235 N 75th Ave Suite F-100, Glendale, AZ 85308 | 2018-03-02 |
1003318585 | Danna Mavis Constance Moisii | Physician Assistant | 18301 N. 79th Ave #g190, Glendale, AZ 85308 | 2018-03-01 |
Find all providers in zip 85308 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619509833 | Helen C Tuwei | Counselor | 4449 W Keating Cir, Glendale, AZ 85308-3549 | 2020-02-05 |
1902469547 | Nustart Inc | Counselor | 6608 San Fernando Rd, Glendale, CA 91201-1703 | 2019-04-18 |
1528529856 | Empowerment Behavioral Care LLC | Counselor | 6448 W Colter St, Glendale, AZ 85301-6527 | 2019-03-28 |
1881168813 | Jessica Martinez | Counselor | 632 Naranja Dr, Glendale, CA 91206-2522 | 2019-01-12 |
1710459359 | David Ibrahim | Counselor | 100 N Brand Blvd Ste 412, Glendale, CA 91203-2614 | 2018-12-20 |
1104308683 | David Gleghorn | Counselor | 6610 N 47th Ave Ste 678, Glendale, AZ 85301-4163 | 2018-08-31 |
1033590344 | Eryn Elizabeth Cloutier | Counselor | 7468 W Irma Ln, Glendale, AZ 85308-9662 | 2015-06-11 |
1326439811 | Robert D Klimek | Counselor | 4425 W Olive Ave Ste 200&140, Glendale, AZ 85302-3843 | 2015-02-05 |
1932549938 | Narine Jugharyan | Counselor | 501 E. Harvard Street, Unit A, Glendale, CA 91205 | 2013-07-05 |
1316385040 | Victor Rivera | Counselor | 4544 San Fernando Rd Ste 201, Glendale, CA 91204-5015 | 2013-06-04 |
Find all providers in GLENDALE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.