NPIMap

Organization Active NPI

Professional Behavioral Health Services of St. Michaels

  • Professional Counselor
  • Saint Michaels, AZ
National Provider Identifier
1225403637
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0146941 Issued in NM
Legal business name
PROFESSIONAL BEHAVIORAL HEALTH SERVICES OF ST. MICHAELS
Doing business as
Professional Counseling Services
Practice address
Lot 165 Blanco Rd
Saint Michaels, AZ 86511-0645
Phone
(928) 871-5409
NPI assigned
Dec 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Authorized official

Name
Mr. Leroy Jim, LPCC
Title
Owner
Phone
(928) 871-5409

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 0146941 NM Primary

Addresses

Primary practice location

Lot 165 Blanco Rd
Saint Michaels, AZ 86511-0645

Mailing address

Lot 165 Blanco Road
Karigan Estates
Saint Michaels, AZ 86511-0645
Phone (928) 871-5409

Other names 1

  • Professional Counseling Services Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1225403637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LOT 165 BLANCO ROAD",
            "address_2": "KARIGAN ESTATES",
            "city": "SAINT MICHAELS",
            "state": "AZ",
            "postal_code": "865110645",
            "telephone_number": "928-871-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LOT 165 BLANCO RD",
            "city": "SAINT MICHAELS",
            "state": "AZ",
            "postal_code": "865110645",
            "telephone_number": "928-871-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL BEHAVIORAL HEALTH SERVICES OF ST. MICHAELS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "JIM",
        "authorized_official_first_name": "LEROY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-871-5409",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0146941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Michaels, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.