NPIMap

Organization Active NPI

Traumacare Institute, PLLC

  • Professional Counselor
  • Snowflake, AZ
National Provider Identifier
1275990368
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-15864 Issued in AZ
Legal business name
TRAUMACARE INSTITUTE, PLLC
Practice address
61 West Center Street
Snowflake, AZ 85937
Phone
(480) 510-6780
NPI assigned
Jan 21, 2016
Last updated
Jan 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Authorized official

Name
Michael Shane Luck, LPCNPI 1659736338
Title
Owner/Manager
Phone
(480) 510-6780

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-15864 AZ Primary

Addresses

Primary practice location

61 West Center Street
Snowflake, AZ 85937

Mailing address

2638 Old Schoolhouse Road
Show Low, AZ 85901
Phone (480) 510-6780

National Provider Directory

National Provider Directory

Locations

61 W Center St
Snowflake, AZ 85937
Phone (480) 510-6780

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453334400000",
    "number": "1275990368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2638 OLD SCHOOLHOUSE ROAD",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "85901",
            "telephone_number": "480-510-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 WEST CENTER STREET",
            "city": "SNOWFLAKE",
            "state": "AZ",
            "postal_code": "85937",
            "telephone_number": "480-510-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAUMACARE INSTITUTE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-21",
        "last_updated": "2016-01-21",
        "status": "A",
        "authorized_official_last_name": "LUCK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "480-510-6780",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-15864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snowflake, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; 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.