IndividualActive
Bevan Gottlieb, LISAC
NPI 1144643628 · Addiction (Substance Use Disorder) Counselor · Prescott, AZ
Provider details
- NPI number
- 1144643628
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Credential
- LISAC
- Sex
- Female
- Sole proprietor
- Yes
- License
- 10822 (AZ)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
115 E Goodwin St
Suite C
Prescott, AZ 86303-3926
Phone: (928) 533-2411
Approximate (ZIP-level) locationGet directions
Mailing address
520 Ellenwood Dr
Prescott, AZ 86303-4122
Registry dates
- Enumerated
- 2014-02-04
- Last updated
- 2014-02-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.