NPIMap

Organization Active NPI

Ephphatha Consulting Services, Inc.

  • Mental Health Counselor
  • Moline, IL
National Provider Identifier
1184938730
Registry record updated Nov 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180006524 Issued in IL
Legal business name
EPHPHATHA CONSULTING SERVICES, INC.
Practice address
2424 40TH Ave
Suite 5
Moline, IL 61265-7215
Phone
(309) 558-9050
NPI assigned
Aug 5, 2010
Last updated
Nov 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2013

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

Authorized official

Name
Dr. Benton K Johnson II, PHDNPI 1326264060
Title
President
Phone
(309) 558-9050

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180006524 IL Primary
Mental Health Counselor 101YM0800X 001063 IA
Professional Counselor 101YP2500X 180006524 IL

Addresses

Primary practice location

2424 40TH Ave
Suite 5
Moline, IL 61265-7215

Mailing address

2424 40TH Ave
Suite 5
Moline, IL 61265-7215
Phone (309) 558-9050

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1280966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385769600000",
    "number": "1184938730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 40TH AVE",
            "address_2": "SUITE 5",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612657215",
            "telephone_number": "309-558-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 40TH AVE",
            "address_2": "SUITE 5",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612657215",
            "telephone_number": "309-558-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPHPHATHA CONSULTING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-05",
        "last_updated": "2013-11-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BENTON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-558-9050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180006524",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001063",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180006524",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

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