NPIMap

Organization Active NPI

Complete Psychological School Services

  • Psychologist
  • Mesa, AZ
National Provider Identifier
1205914264
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
COMPLETE PSYCHOLOGICAL SCHOOL SERVICES
Practice address
1550 N Stapley Dr
40
Mesa, AZ 85203-3705
Phone
(480) 644-9567
Fax
(480) 644-0848
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Joseph Homer Bourgoine, M.A., M. ED.
Title
School Psychologist
Phone
(480) 644-9567

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

1550 N Stapley Dr
40
Mesa, AZ 85203-3705

Mailing address

1550 N Stapley Dr
40
Mesa, AZ 85203-3705
Phone (480) 644-9567

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205914264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N STAPLEY DR",
            "address_2": "40",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852033705",
            "telephone_number": "480-644-9567",
            "fax_number": "480-644-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N STAPLEY DR",
            "address_2": "40",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852033705",
            "telephone_number": "480-644-9567",
            "fax_number": "480-644-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE PSYCHOLOGICAL SCHOOL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOURGOINE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "HOMER",
        "authorized_official_title_or_position": "SCHOOL PSYCHOLOGIST",
        "authorized_official_telephone_number": "480-644-9567",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A., M. ED."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 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.