NPIMap

Organization Active NPI

Lifeline Professional Counseling Services, Inc

Doing business as Lifeline East

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mesa, AZ
National Provider Identifier
1194285643
Registry record updated May 27, 2020
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
LIFELINE PROFESSIONAL COUNSELING SERVICES, INC
Doing business as
Lifeline East
Practice address
1423 S Higley Rd Ste 103
Mesa, AZ 85206-3449
Phone
(480) 641-1165
Fax
(480) 641-9026
NPI assigned
Mar 21, 2019
Last updated
May 27, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
LIFELINE PROFESSIONAL COUNSELING SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Authorized official

Name
John Delorenzo
Title
Cfo
Phone
(480) 641-1165

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1423 S Higley Rd Ste 103
Mesa, AZ 85206-3449

Mailing address

335 N Alma School Rd Ste E
Chandler, AZ 85224-4363
Phone (480) 641-1165

Other names 1

  • Lifeline East Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lifeline Professional Counseling Services Inc8 organizations share this tax ID, including this one
Part of
Lifeline Professional Counseling Services Inc

Other organizations with this tax ID 7

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

Locations

17235 N 75th Ave
Ste F100
Glendale, AZ 85308
Phone 4806411165 ext. 3

1423 S Higley Rd
Ste 103
Mesa, AZ 85206
Phone (480) 369-1870

Practitioners & affiliated clinicians

Practitioners 46

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 46

NPI Registry JSON

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1194285643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 N ALMA SCHOOL RD STE E",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244363",
            "telephone_number": "480-641-1165",
            "fax_number": "480-641-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 S HIGLEY RD STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063449",
            "telephone_number": "480-641-1165",
            "fax_number": "480-641-9026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE PROFESSIONAL COUNSELING SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFELINE PROFESSIONAL COUNSELING SERVICES, INC",
        "enumeration_date": "2019-03-21",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "DELORENZO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "480-641-1165"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifeline East",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.