NPIMap

Organization Active NPI

Family Ties Counseling and Coaching LLC

  • Mental Health Counselor
  • Phoenix, AZ
National Provider Identifier
1295305175
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FAMILY TIES COUNSELING AND COACHING LLC
Practice address
3420 E Shea Blvd
Phoenix, AZ 85028-3345
Phone
(602) 730-4105
NPI assigned
Jul 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Authorized official

Name
Mrs. Heather Marie Ford, LPCNPI 1093275018
Title
Owner/Clinician
Phone
(602) 730-4105

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

3420 E Shea Blvd
Phoenix, AZ 85028-3345

Mailing address

3420 E Shea Blvd
Phoenix, AZ 85028-3345

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1295305175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 E SHEA BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 E SHEA BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283345",
            "telephone_number": "602-730-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY TIES COUNSELING AND COACHING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "602-730-4105",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.