BEVAN GOTTLIEB (NPI# 1144643628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144643628 |
| Entity Type | Individual |
| Full Name | BEVAN GOTTLIEB |
| Credential | LISAC |
| Practice Address |
115 E Goodwin St Suite C Prescott AZ 86303-3926 |
| Mailing Address |
520 Ellenwood Dr Prescott AZ 86303-4122 |
| Practice Telephone | 9285332411 |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2014-02-04 |
| 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) |
10822 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
115 E GOODWIN ST SUITE C |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86303-3926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801814066 | Eric Dale Brummel | Physical Therapist | 115 E Goodwin St, Suite E1, Prescott, AZ 86303-3926 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518447598 | Jacqueline Schlosser | Respite Care | 237 S. Washington Ave., Prescott, AZ 86303 | 2018-08-18 |
| 1033699210 | Anna Rachel Seno | Psychologist | 300 S Granite Street, Prescott, AZ 86303 | 2018-08-17 |
| 1871944322 | Jessie Deverna | Counselor | 450 W Goodwin St Suite 103b, Prescott, AZ 86303 | 2016-06-27 |
| 1154782845 | Walmart | Pharmacy | 1120 N. Opal Dr., Prescott, AZ 86303 | 2016-03-09 |
| 1710377650 | Compass Recovery Center LLC | Clinic/Center | 711 S. Granite St, Prescott, AZ 86303 | 2015-01-30 |
| 1154727527 | Anne Gurley Klever | Pharmacist | 500 Arizona 89, Prescott, AZ 86303 | 2014-11-13 |
| 1295131860 | Kathi Sabot | Registered Nurse | 146 S. Granite Street, Prescott Unified School District, Prescott, AZ 86303 | 2014-11-10 |
| 1457697989 | Kim K. Mcintyre | Counselor | 505 S. Cortez St., Prescott, AZ 86303 | 2013-01-03 |
| 1578885257 | Wesley Carl Kitchens | Counselor | 315 W Goodwin St, Prescott, AZ 86303 | 2010-02-22 |
| 1588805907 | Jacob Lee Bean | Physical Therapist | 6820 El Dorado Dr, Prescott, AZ 86303 | 2009-03-14 |
| Find all providers in zip 86303 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891300299 | Roundsville Drug and Alcohol Treatment of Arizona | Counselor | 610 N Bagby Dr, Prescott, AZ 86301-2588 | 2020-09-11 |
| 1619588209 | Teri Sebastian | Counselor | 240 S Montezuma St Ste 201e, Prescott, AZ 86303-4712 | 2020-08-16 |
| 1588287858 | Grace & Peace Counseling, LLC | Counselor | 240 S Montezuma St Ste 106, Prescott, AZ 86303-4712 | 2020-05-21 |
| 1619527850 | Taylor Counseling Services Taylor Tlc | Counselor | 1000 Ainsworth Dr Ste B215, Prescott, AZ 86305-3411 | 2019-09-19 |
| 1023527801 | William James Bilbray | Counselor | 702 W Hillside Ave, Prescott, AZ 86301-1913 | 2017-09-25 |
| 1831583269 | Renee Podraza | Counselor | 843 Miller Valley Rd Ste 203, Prescott, AZ 86301-1821 | 2015-03-24 |
| 1013314988 | Mary Jo Fleming | Counselor | 919 12th Place Ste 13, Recovery In The Pines, Prescott, AZ 86301 | 2014-11-20 |
| 1891056461 | Greta Blankman Stromberg | Counselor | 1320 W Gurley St, Prescott, AZ 86305-2854 | 2012-05-30 |
| 1982970034 | Henry Dayton Turberville | Counselor | 214 N. Arizona Ave., Prescott, AZ 86301 | 2012-03-22 |
| 1578885257 | Wesley Carl Kitchens | Counselor | 315 W Goodwin St, Prescott, AZ 86303 | 2010-02-22 |
| Find all providers in PRESCOTT | ||||
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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.