NPIMap

Organization Active NPI

Scottsdale Pediatric Behavioral Services PLLC

  • Behavior Analyst
  • Scottsdale, AZ
National Provider Identifier
1124577192
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
SCOTTSDALE PEDIATRIC BEHAVIORAL SERVICES PLLC
Practice address
22555 N Miller Rd
Suite 100
Scottsdale, AZ 85255-4944
Phone
(480) 410-4040
NPI assigned
Sep 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Authorized official

Name
Dr. Jacob Boney, PSY.D.NPI 1013341395
Title
Clinical Director
Phone
(480) 410-4040

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

22555 N Miller Rd
Suite 100
Scottsdale, AZ 85255-4944

Mailing address

22555 N Miller Rd
Suite 100
Scottsdale, AZ 85255-4944

National Provider Directory

National Provider Directory

Locations

22555 N Miller Rd
Ste 100
Scottsdale, AZ 85255
Phone (480) 410-4040

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1124577192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22555 N MILLER RD",
            "address_2": "SUITE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852554944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22555 N MILLER RD",
            "address_2": "SUITE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852554944",
            "telephone_number": "480-410-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTSDALE PEDIATRIC BEHAVIORAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "BONEY",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "480-410-4040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; 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.