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NPI Code Detail

MEDICARE: MR. JOHN HOHL LISAC

MEDICARE: MR. JOHN HOHL LISAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLISAC1634AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LISAC1634OTHERAZTHERAPIST

General Provider Information

NPI Number : 1932271350
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN HOHL LISAC
Provider Business Mailing Address
First Line : 2017 N 7TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85006-2102
Country : US
Telephone Number : 602-452-4684
Fax Number : 602-358-0399
Provider Business Practice Location Address
First Line : 3306 W CATALINA DR
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-5291
Country : US
Telephone Number : 602-353-0703
Fax Number : 602-353-0715
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 07/08/2007

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