Active NPI
Shawn Paul Backs, MA, LPC
- Mental Health Counselor
- Yuma, AZ
National Provider Identifier
1497293880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC 16512
- Practice address
- 2749 W County 14TH St
Yuma, AZ 85365-9757 - Phone
- (928) 985-1186
- NPI assigned
- Feb 6, 2017
- Last updated
- Jul 15, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC 16512 | AZ | Primary |
Addresses
Primary practice location
2749 W County 14TH St
Yuma, AZ 85365-9757
Mailing address
791 S 4TH Ave Ste a
Yuma, AZ 85364-3067
Phone (928) 783-3986
Other practice location 1
791 S 4th Ave Ste A
Yuma, AZ 85364-3067
Phone (928) 783-3986 ext. 17919
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC 16512 | AZ | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affordable Counseling of Yuma | Current | Accepting new patients | |
| Horizon Health & Wellness, Inc. | Past | Accepting new patients | |
| Horizon Health and Wellness, Inc. | Past | Accepting new patients | |
| Horizon Health and Wellness, Inc. | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Yuma, AZ
- NPI 1932771268
-
dba Mountain Health & Wellness
- Community/Behavioral Health Agency
- Oracle, AZ
- NPI 1659458750
-
- Federally Qualified Health Center (FQHC)
- Globe, AZ
- NPI 1689436412
-
- Federally Qualified Health Center (FQHC)
- Oracle, AZ
- NPI 1710366737
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626307200000",
"number": "1497293880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "791 S 4TH AVE STE A",
"city": "YUMA",
"state": "AZ",
"postal_code": "853643067",
"telephone_number": "928-783-3986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2749 W COUNTY 14TH ST",
"city": "YUMA",
"state": "AZ",
"postal_code": "853659757",
"telephone_number": "928-985-1186"
}
],
"practiceLocations": [
{
"address_1": "791 S 4th Ave Ste A",
"address_purpose": "LOCATION",
"city": "Yuma",
"state": "AZ",
"postal_code": "853643067",
"country_code": "US",
"telephone_number": "928-783-3986 x17919",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BACKS",
"first_name": "SHAWN",
"middle_name": "PAUL",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-06",
"last_updated": "2021-07-15",
"certification_date": "2021-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "LPC 16512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.