Paradise Counseling & Consultation Center PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

503 Issued in AZ

Legal business name

PARADISE COUNSELING & CONSULTATION CENTER PC

Practice address

11020 N Tatum Blvd
Phoenix, AZ 85028-6072

Phone

(602) 996-8619

Fax

(602) 996-7932

NPI assigned

May 23, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Martin E Keller, EDDNPI 1700831427

Title

Psychologist

Phone

(602) 996-8619

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Martin E Keller, EDD ABPP

  • Clinical Psychologist
  • Phoenix, AZ
  • NPI 1700831427
  NPD (past) Authorized official
• Patricia Brunskill, MA LPC

  • Professional Counselor
  • Phoenix, AZ
  • NPI 1881684009
  NPD (past)
• Jennifer McCombs, CSW

  • Mental Health Counselor
  • Phoenix, AZ
  • NPI 1588901565
  NPD (past)

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1376701508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11020 N TATUM BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286072",
            "telephone_number": "602-996-8619",
            "fax_number": "602-996-7932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11020 N TATUM BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286072",
            "telephone_number": "602-996-8619",
            "fax_number": "602-996-7932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE COUNSELING & CONSULTATION CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-23",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "602-996-8619",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "EDD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paradigm Diagnostics Inc
• Paradigm Shift Therapies, LLC
• Patricia Kate Paradis, FNP-C
• Paradise Anesthesia, PLLC
• Paradise Behavioral Health, LLC.
• Paradise Healthcare LLC
• Paradise Hearing and Balance LLC
• Paradise Home Care LLC
• Paradise Patient Care, LLC
• Paradise Ridge Family Dentistry LLC

• Clinical Psychologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.