Greater New Life Worship Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

GREATER NEW LIFE WORSHIP CENTER

Practice address

2450 W Glenrosa Ave Unit 24
Phoenix, AZ 85015-4989

Phone

(803) 293-5149

NPI assigned

Oct 10, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Tracey Denise Davis

Title

Executive Director/Office /Manager

Phone

(803) 293-5149

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1326763574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W GLENROSA AVE UNIT 24",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850154989",
            "telephone_number": "803-293-5149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 W GLENROSA AVE UNIT 24",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850154989",
            "telephone_number": "803-293-5149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER NEW LIFE WORSHIP CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/OFFICE /MANAGER",
        "authorized_official_telephone_number": "803-293-5149",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Phoenix, AZ
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.