NPIMap

Organization Active NPI

Phoenix Wellness Center

  • Mental Health Counselor
  • Phoenix, AZ
National Provider Identifier
1194232512
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CSLG8879 Issued in AZ
Legal business name
PHOENIX WELLNESS CENTER
Practice address
2060 W Whispering Wind Dr Ste 270
Phoenix, AZ 85085
Phone
(480) 653-8434
Fax
(623) 258-4077
NPI assigned
Jan 8, 2018
Last updated
Aug 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Authorized official

Name
Tonya Kinnaman, MA, NCC, LPCNPI 1891014486
Title
Clinical Director
Phone
(480) 653-8434

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 OTC8779 AZ
Mental Health Counselor 101YM0800X CSLG8879 AZ Primary

Addresses

Primary practice location

2060 W Whispering Wind Dr Ste 270
Phoenix, AZ 85085

Mailing address

2060 W Whispering Wind Dr Ste 270
Phoenix, AZ 85085-2869
Phone (480) 653-8434

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Wellness Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533772800000",
    "number": "1194232512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 W WHISPERING WIND DR STE 270",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850852869",
            "telephone_number": "480-653-8434",
            "fax_number": "623-258-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 W WHISPERING WIND DR STE 270",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85085",
            "telephone_number": "480-653-8434",
            "fax_number": "623-258-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-08-09",
        "status": "A",
        "authorized_official_last_name": "KINNAMAN",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "480-653-8434",
        "authorized_official_credential": "MA, NCC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "OTC8779",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "CSLG8879",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 9, 2018; 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.