Active NPI
Jeff Komar
- Mental Health Counselor
- Mesa, AZ
National Provider Identifier
1215213962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LAC-13109
- Practice address
- 1839 S Alma School Rd
Suite # 226
Mesa, AZ 85210-3023 - Phone
- (480) 655-7933
- Fax
- (480) 649-1298
- NPI assigned
- Oct 26, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LAC-13109 | AZ | Primary |
Addresses
Primary practice location
1839 S Alma School Rd
Suite # 226
Mesa, AZ 85210-3023
Mailing address
1839 S Alma School Rd
Suite # 226
Mesa, AZ 85210-3023
Phone (480) 655-7933
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAC-13109 | AZ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319587200000",
"number": "1215213962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1839 S ALMA SCHOOL RD",
"address_2": "SUITE # 226",
"city": "MESA",
"state": "AZ",
"postal_code": "852103023",
"telephone_number": "480-655-7933",
"fax_number": "480-649-1298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1839 S ALMA SCHOOL RD",
"address_2": "SUITE # 226",
"city": "MESA",
"state": "AZ",
"postal_code": "852103023",
"telephone_number": "480-655-7933",
"fax_number": "480-649-1298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOMAR",
"first_name": "JEFF",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-26",
"last_updated": "2011-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "LAC-13109",
"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 Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.