NPIMap

Organization Active NPI

Quad City Behavioral Health Associates, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rock Island, IL
National Provider Identifier
1174016877
Registry record updated Jul 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
QUAD CITY BEHAVIORAL HEALTH ASSOCIATES, PLLC
Practice address
4709 44TH St Ste 5
Rock Island, IL 61201-7187
Phone
(309) 306-1648
Fax
(309) 213-9438
NPI assigned
Jun 7, 2018
Last updated
Jul 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2023

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

Authorized official

Name
Brandon Alan Kutmas, LCPC, LMHCNPI 1033663067
Title
Ceo
Phone
(309) 558-0258

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 Counselor 101YM0800X 180.011637 IL
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

4709 44TH St Ste 5
Rock Island, IL 61201-7187

Mailing address

4709 44TH St Ste 5
Rock Island, IL 61201-7187
Phone (309) 558-0258

National Provider Directory

National Provider Directory

Locations

4703 44th St
Ste 2
Rock Island, IL 61201

4709 44th St
Ste 5
Rock Island, IL 61201
Phone (309) 558-0258

Practitioners & affiliated clinicians

Practitioners 10

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": "1528329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688860800000",
    "number": "1174016877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 44TH ST STE 5",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017187",
            "telephone_number": "309-558-0258",
            "fax_number": "309-213-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 44TH ST STE 5",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017187",
            "telephone_number": "309-306-1648",
            "fax_number": "309-213-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUAD CITY BEHAVIORAL HEALTH ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-07",
        "last_updated": "2023-07-09",
        "certification_date": "2023-07-09",
        "status": "A",
        "authorized_official_last_name": "KUTMAS",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-558-0258",
        "authorized_official_credential": "LCPC, LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.011637",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.