Healthcare Provider Details

I. General information

NPI: 1821903493
Provider Name (Legal Business Name): ELIZABETH BUDGE MA, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIZZI BUDGE MA, LAC

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3009 N WEST ST
FLAGSTAFF AZ
86004-3444
US

IV. Provider business mailing address

4101 S NICHOLAS ST
FLAGSTAFF AZ
86005-6917
US

V. Phone/Fax

Practice location:
  • Phone: 928-719-4009
  • Fax:
Mailing address:
  • Phone: 607-232-6303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLAC-24175
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: