Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bevan Gottlieb, LISAC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1144643628

Bevan Gottlieb, LISAC is an Addiction (Substance Use Disorder) Counselor in Prescott, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2014

Practice location Address checks out

115 E Goodwin St Ste C
Prescott, AZ 86303-3926
Phone: (928) 533-2411
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 10822 (AZ)

Record details

NPI number1144643628
Entity typeIndividual (Type 1)
GenderFemale
Credentials LISAC
Sole proprietorYes
NPI enumeratedFebruary 4, 2014
Last updated in NPPESFebruary 4, 2014
Mailing address520 Ellenwood Dr, Prescott, AZ 86303-4122

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