NPIMap

Organization Active NPI

Jewish Family & Children'S Service

  • Community/Behavioral Health Agency
  • Glendale, AZ
National Provider Identifier
1316009145
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
JEWISH FAMILY & CHILDREN'S SERVICE
Practice address
5701 W Talavi Blvd Ste 180
Glendale, AZ 85306-1888
Phone
(623) 486-8202
Fax
(623) 486-2739
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Authorized official

Name
Dr. Lorrie Henderson, PHD, MBA, LCSW
Title
President and Ceo
Phone
(602) 279-7655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

5701 W Talavi Blvd Ste 180
Glendale, AZ 85306-1888

Mailing address

4747 N 7TH St Ste 100
Phoenix, AZ 85014-3654
Phone (602) 279-7655

Other identifiers 1

IdentifierTypeStateIssuer
185664MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040312001009 AZ Part B Supplier - Clinic/Group Practice 9234028671 Receives reassigned benefits from 136 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gilbert, AZ; Phoenix, AZ

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1316009145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 N 7TH ST STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850143654",
            "telephone_number": "602-279-7655",
            "fax_number": "602-253-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 W TALAVI BLVD STE 180",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853061888",
            "telephone_number": "623-486-8202",
            "fax_number": "623-486-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWISH FAMILY & CHILDREN'S SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "LORRIE",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "602-279-7655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, MBA, LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185664",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.