Individual provider Active NPI

Tina Beth McIntire, MA

  • Mental Health Counselor
  • Santee, CA
National Provider Identifier
1184769648
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
9905 Prospect Ave
Santee, CA 92071-4318
Phone
(619) 333-9003
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X LADAC LR 160 112 CA
Addiction (Substance Use Disorder) Counselor 101YA0400X CADAC II A677011 CA

Addresses

Primary practice location

9905 Prospect Ave
Santee, CA 92071-4318

Mailing address

PO Box 862
Pine Valley, CA 91962-0862
Phone (619) 322-7776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CADAC II A677011CAMDAddiction (Substance Use Disorder) Counselor
LADAC LR 160 112CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1184769648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 862",
            "city": "PINE VALLEY",
            "state": "CA",
            "postal_code": "919620862",
            "telephone_number": "619-322-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9905 PROSPECT AVE",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920714318",
            "telephone_number": "619-333-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTIRE",
        "first_name": "TINA",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "LADAC LR 160 112",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CADAC II A677011",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.