Interception Counseling Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

INTERCEPTION COUNSELING SERVICES, LLC

Practice address

40 N Swan Rd Ste 114
Tucson, AZ 85711-3019

Phone

(520) 261-0608

Fax

(520) 422-4911

NPI assigned

Mar 4, 2020

Organization subpart

No

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

Authorized official

Name

George Washington Kelly, MA, LPCNPI 1770131245

Title

Professional Counselor

Phone

(520) 261-0608

Specialties & licenses 1

Addresses

Practitioners 1

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

• George Washington Kelly, MA, LPC

  • Professional Counselor
  • Tucson, AZ
  • NPI 1770131245
  NPD Authorized official

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1346875986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 S WHITE SPAR TRL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857470012",
            "telephone_number": "520-429-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 N SWAN RD STE 114",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113019",
            "telephone_number": "520-261-0608",
            "fax_number": "520-422-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERCEPTION COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "WASHINGTON",
        "authorized_official_title_or_position": "PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "520-261-0608",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.