NPIMap

Organization Active NPI

Samaritan Counseling Center

  • Community/Behavioral Health Agency
  • Upland, CA
National Provider Identifier
1366572968
Registry record updated Oct 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
PSY 19880 Issued in CA
Legal business name
SAMARITAN COUNSELING CENTER
Practice address
1126 W Foothill Blvd
Suite 110
Upland, CA 91786-3768
Phone
(909) 985-0513
Fax
(909) 985-7193
NPI assigned
Mar 6, 2007
Last updated
Oct 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2012

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

Authorized official

Name
Dr. Douglas G McKown, PSY. D.NPI 1659478113
Title
Executive Director
Phone
(909) 985-0513

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
Community/Behavioral Health Agency 251S00000X PSY 19880 CA Primary

Addresses

Primary practice location

1126 W Foothill Blvd
Suite 110
Upland, CA 91786-3768

Mailing address

1126 W Foothill Blvd
Suite 110
Upland, CA 91786-3768
Phone (909) 985-0513

Other identifiers 1

IdentifierTypeStateIssuer
1659478113OtherCADR. DOUG MCKOWN

Other names 1

  • Samaritan Center for Pastoral Counseling Former legal business name

National Provider Directory

National Provider Directory

Locations

1126 W Foothill Blvd
Ste 110
Upland, CA 91786
Phone (909) 985-0513

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351468800000",
    "number": "1366572968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 W FOOTHILL BLVD",
            "address_2": "SUITE 110",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863768",
            "telephone_number": "909-985-0513",
            "fax_number": "909-985-7193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 W FOOTHILL BLVD",
            "address_2": "SUITE 110",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863768",
            "telephone_number": "909-985-0513",
            "fax_number": "909-985-7193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2012-10-29",
        "status": "A",
        "authorized_official_last_name": "MCKOWN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-985-0513",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY. D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "PSY 19880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. DOUG MCKOWN",
            "identifier": "1659478113",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Center for Pastoral Counseling",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; 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.