Organization Active NPI

Ocotillo Counseling, LLC

  • Mental Health Counselor
  • Phoenix, AZ
National Provider Identifier
1043812597
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
OCOTILLO COUNSELING, LLC
Practice address
1300 E Missouri Ave Ste 120
Phoenix, AZ 85014-2372
Phone
(480) 930-0390
NPI assigned
Nov 10, 2020
Last updated
Jan 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gisel Trevino-Martinez, LCSWNPI 1942840103
Title
Owner
Phone
(480) 930-0390

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1300 E Missouri Ave Ste 120
Phoenix, AZ 85014-2372

Mailing address

1300 E Missouri Ave Ste 120
Phoenix, AZ 85014-2372
Phone (480) 930-0390

Other identifiers 1

IdentifierTypeStateIssuer
1942840103OtherAZCOMMERCIAL

National Provider Directory

National Provider Directory

Locations

7000 N 16th St
Ste 120146
Phoenix, AZ 85020

1300 E Missouri Ave
Ste 120
Phoenix, AZ 85014
Phone (480) 930-0390

6619 N Scottsdale Rd
Ste 21
Scottsdale, AZ 85250

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1043812597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E MISSOURI AVE STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142372",
            "telephone_number": "480-930-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E MISSOURI AVE STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142372",
            "telephone_number": "480-930-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCOTILLO COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-10",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "TREVINO-MARTINEZ",
        "authorized_official_first_name": "GISEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-930-0390",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "1942840103",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.