NPIMap

Organization Active NPI

Empact - Suicide Prevention Center

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1467293357
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EMPACT - SUICIDE PREVENTION CENTER
Practice address
1035 E Jefferson St
Phoenix, AZ 85034-2295
Phone
(602) 251-0650
Fax
(602) 251-0632
NPI assigned
Jun 4, 2024
Last updated
Jun 4, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
EMPACT - SUICIDE PREVENTION CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Brittany Rasmussen
Title
Credentialing Coordinator
Phone
(480) 784-1514

Specialties & licenses 1

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

Addresses

Primary practice location

1035 E Jefferson St
Phoenix, AZ 85034-2295

Mailing address

618 S Madison Dr
Tempe, AZ 85281-7248
Phone (480) 784-1514

Other identifiers 1

IdentifierTypeStateIssuer
589359MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
The Suicide Prevention Ctr13 organizations share this tax ID, including this one
Part of
The Suicide Prevention Ctr

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1467293357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 S MADISON DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852817248",
            "telephone_number": "480-784-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 E JEFFERSON ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850342295",
            "telephone_number": "602-251-0650",
            "fax_number": "602-251-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPACT - SUICIDE PREVENTION CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMPACT - SUICIDE PREVENTION CENTER",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "RASMUSSEN",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "480-784-1514"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "589359",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.