Foundation for Healing, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

FOUNDATION FOR HEALING, LLC

Practice address

4111 E Valley Auto Dr Ste 201
Mesa, AZ 85206-4609

Phone

(480) 608-5250

Fax

(480) 608-5251

NPI assigned

May 7, 2018

Organization subpart

No

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

Authorized official

Name

Deborah M. Johansen, MS, LPC, NCCNPI 1417409483

Title

Clinical Director

Phone

(480) 608-5250

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Deborah M. Johansen, LPC, CLINICAL SUP.

  • Professional Counselor
  • Mesa, AZ
  • NPI 1417409483
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1205325198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 E VALLEY AUTO DR STE 201",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064609",
            "telephone_number": "480-608-5250",
            "fax_number": "480-608-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 E VALLEY AUTO DR STE 201",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064609",
            "telephone_number": "480-608-5250",
            "fax_number": "480-608-5251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14325 E BUFFALO ST",
            "address_purpose": "LOCATION",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852955907",
            "country_code": "US",
            "telephone_number": "480-608-5250",
            "fax_number": "480-608-5251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOUNDATION FOR HEALING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-07",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "JOHANSEN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "480-608-5250",
        "authorized_official_credential": "MS, LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "AZ",
            "license": "LPC-14026",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273868",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1417409483",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Multi-Specialty Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.