MELISSA BORDENKIRCHER LAC
NPI 1790499184
Counselor - Professional in Glendale, AZ

Active since January 10, 2023PECOS EnrolledAccepts Medicare Assignment
18001 N 79TH AVE STE A10, GLENDALE, AZ 85308(623) 244-0834 Get Directions Write a Review

NPPES record last updated: June 1, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 1, 2026, Jun 18, 2025, Mar 10, 2023 and 1 more (4 updates tracked since 2023).

About Melissa Bordenkircher Lac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MELISSA BORDENKIRCHER LAC (NPI 1790499184) is an individual professional provider in Glendale, Arizona, licensed in Arizona (LPC23920) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Glendale, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1790499184
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMELISSA BORDENKIRCHERCredential: LAC
Location Address18001 N 79TH AVE STE A10Glendale, AZ 85308-8389
Mailing Address7982 W Martha WayPeoria, AZ 85381-4350 · (623) 244-0834
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateJanuary 10, 2023
Last NPPES UpdateJune 1, 20264 updates tracked since enumeration
NPPES CertifiedJune 1, 2026
NPI 1790499184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in AZ · LPC23920
18001 N 79TH AVE STE A10, Glendale, AZ 85308

Secondary Practice Location 1

Location 113980 N 67th Ave Ste 1Glendale, AZ 85306-3715 · Phone (623) 755-9690 · Fax (623) 230-2957

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Melissa Bordenkircher Lac is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113433814
PECOS Enrollment IDI20250721000966
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Professional)
18001 N 79TH AVE STE A10
GLENDALE, AZ 85308
Counselor (Professional)
18001 N 79TH AVE STE A10
GLENDALE, AZ 85308
Social Worker (Clinical)
18001 N 79TH AVE STE A10
GLENDALE, AZ 85308
Social Worker (Clinical)
18001 N 79TH AVE STE A10
GLENDALE, AZ 85308
Counselor (Professional)
18001 N 79TH AVE STE A10
GLENDALE, AZ 85308
Counselor (Mental Health)
18001 N 79TH AVE STE A10
GLENDALE, AZ 85308
Nurse Practitioner (Psychiatric/Mental Health)
18001 N 79TH AVE STE A10
GLENDALE, AZ 85308
Social Worker (Clinical)
18001 N 79TH AVE STE A10
GLENDALE, AZ 85308

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790499184, enumerated as an "individual" on January 10, 2023.

The provider is located at 18001 N 79TH AVE STE A10 GLENDALE, AZ 85308 and the phone number is (623) 244-0834.

Counselor with taxonomy code 101YP2500X and a focus in Professional.

The provider might be accepting Accepts: Blue Cross Blue Shield of Arizona and Oscar Health. Please consult your insurance carrier or call the provider to verify.