Individual provider · Type 1 NPI
Bevan Gottlieb, LISAC
Addiction (Substance Use Disorder) Counselor · Prescott, AZ
NPI number
1144643628
Active
Practice location
115 E Goodwin St, Suite C
Prescott, AZ 86303-3926
Mailing address
520 Ellenwood Dr
Prescott, AZ 86303-4122
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 10822 (AZ) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Another provider at this address
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About NPI 1144643628
Bevan Gottlieb, LISAC's National Provider Identifier is 1144643628, issued on Feb 4, 2014. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Prescott, AZ. The record was last updated on Feb 4, 2014.