Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

NPI 1881374148

Individual provider · NPI 1881374148 Deactivated

This NPI was deactivated on September 17, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1881374148 is a Mental Health Counselor. Graduated from University of Arizona College of Medicine - Phoenix in 2019, 7 years ago. Accepts Medicare assignment.

Years since qualifying
7
Trained at
University of Arizona College of Medicine - Phoenix

Practice location Incomplete address

The federal record is missing the street or ZIP for this provider.

Specialties & licences

Record details

NPI number1881374148
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolUNIVERSITY OF ARIZONA COLLEGE OF MEDICINE - PHOENIX
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount