NPIMap

Organization Active NPI

Lifeline Professional Counseling Services, Inc

Doing business as Lifeline Central

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tempe, AZ
National Provider Identifier
1508368986
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
OTC8596 Issued in AZ
Legal business name
LIFELINE PROFESSIONAL COUNSELING SERVICES, INC
Doing business as
Lifeline Central
Practice address
4515 S McClintock Dr Ste 114
Tempe, AZ 85282-7381
Phone
(480) 641-1165
NPI assigned
Mar 1, 2018
Last updated
Sep 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Authorized official

Name
John Delorenzo
Title
Administrative Director
Phone
(480) 641-1165

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X OTC8596 AZ Primary

Addresses

Primary practice location

4515 S McClintock Dr Ste 114
Tempe, AZ 85282-7381

Mailing address

335 N Alma School Rd Ste E
Chandler, AZ 85224-4363
Phone (480) 641-1165

Other names 1

  • Lifeline Central Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lifeline Professional Counseling Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

45 E Monterey Way
Ste 100
Phoenix, AZ 85012
Phone (480) 351-6520

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1508368986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 N ALMA SCHOOL RD STE E",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244363",
            "telephone_number": "480-641-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 S MCCLINTOCK DR STE 114",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827381",
            "telephone_number": "480-641-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE PROFESSIONAL COUNSELING SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-01",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "DELORENZO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "480-641-1165"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "AZ",
            "license": "OTC8596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifeline Central",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.