BONNY MARGUERITE BEACH LISAC NPI 1578999041

Counselor in Phoenix, AZ

NPI 1578999041 Individual Female Counselor

About BONNY BEACH

Bonny Beach is a provider established in Phoenix, Arizona and her medical specialization is counselor. The NPI number of Bonny Beach is 1578999041 and was assigned on September 2013. The practitioner's primary taxonomy code is 101Y00000X with license number LISAC 11484 (AZ). The provider is registered as an individual and her NPI record was last updated 8 years ago.

Bonny Beach is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

NPI

1578999041

Provider Name BONNY MARGUERITE BEACH LISAC
Provider Location Address1648 S 16TH ST PHOENIX, AZ 85034
Provider Mailing Address4205 N 2ND DR PHOENIX, AZ 85013
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date09-17-2013
Last Update Date09-17-2013


Primary Taxonomy

Taxonomy Code101Y00000X
ClassificationCounselor
TypeBehavioral Health & Social Service Providers
License No.LISAC 11484
License StateAZ
Taxonomy DescriptionA provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Business Address

BONNY MARGUERITE BEACH LISAC
1648 S 16TH ST
PHOENIX, AZ
ZIP 85034
Phone: (602) 448-0935
Fax: (602) 532-7202

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Mailing Address

BONNY MARGUERITE BEACH LISAC
4205 N 2ND DR
PHOENIX, AZ
ZIP 85013
Phone: (602) 448-0935
Fax: (602) 532-7202



Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1609200237SEQUOIA SUPPORT SEVICES
Organization
Community/Behavioral Health1648 S 16TH ST
PHOENIX, AZ 85034
(602) 448-0935
1003030107 PHILIP LEE MCDONALD LMSW
Individual
Counselor (Mental Health)1648 S 16TH ST
PHOENIX, AZ 85034

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.