DR. SUZANNE ANDRY BOTELLO (NPI# 1922621242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1922621242 |
Entity Type | Individual |
Full Name | DR. SUZANNE ANDRY BOTELLO |
Credential | PHD, LPC |
Practice Address |
1538 W Daydream Dr Flagstaff AZ 86001-7212 |
Practice Telephone | 9282663770 |
Mailing Telephone | 9282663770 |
Enumeration Date | 2020-05-20 |
Last Update Date | 2020-05-20 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YP2500X |
Counselor Specialization: Professional |
LPC-2539 | AZ | Behavioral Health & Social Service Providers |
Y | 103TC1900X |
Psychologist Specialization: Counseling |
4765 | AZ | Behavioral Health & Social Service Providers |
N | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
4765 | AZ | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | TRANSACTION PRIVILEGE TAX NUMBER | 03029048 | 01 |
Street Address |
1538 W DAYDREAM DR |
City | FLAGSTAFF |
State | AZ |
Zip Code | 86001-7212 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
Find all providers in zip 86001 |
Taxonomy Code | 103TC1900X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Counseling |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427608892 | David G Dubner | Psychologist | 709 N Humphreys St, Flagstaff, AZ 86001-3025 | 2019-09-17 |
1720597040 | Lore M Dickey | Psychologist | 2501 N 4th St Ste 18d, Flagstaff, AZ 86004-3701 | 2017-09-29 |
1801062286 | Laura Lyn | Psychologist | 123 S San Francisco St, Suite 12, Flagstaff, AZ 86001-5796 | 2008-05-05 |
1821036344 | Linnea Suzanne Lei | Psychologist | 416 N Kendrick St, Suite 4, Flagstaff, AZ 86001-1598 | 2006-06-04 |
1154324473 | James Andrew Hogg | Psychologist | 408 N Kendrick St, Ste 4, Flagstaff, AZ 86001-1582 | 2005-05-31 |
1992212716 | Kelly C Donohue | Psychologist | 2187 N Vickey St, Flagstaff, AZ 86004-6121 | 2018-01-02 |
1124531173 | Lauren Timmermans | Psychologist | 519 N Leroux St, Flagstaff, AZ 86001-3221 | 2017-11-13 |
1164974721 | Sherri Ruggiero | Psychologist | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2016-10-31 |
1609282268 | Christopher Johann Margeson | Psychologist | 408 N Kendrick St Ste 4, Flagstaff, AZ 86001-1582 | 2014-07-03 |
1639226160 | Steven C Finger | Psychologist | 408 N Kendrick St, Suite 3, Flagstaff, AZ 86001-1582 | 2007-01-05 |
Find all providers in FLAGSTAFF |
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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.