Momentum Counseling Services

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

MOMENTUM COUNSELING SERVICES

Practice address

5902 W Cactus Rd
Glendale, AZ 85304-1710

Phone

(623) 377-4738

NPI assigned

Sep 29, 2023

Last updated

Sep 29, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alan KetterlingNPI 1306333133

Title

Owner

Phone

(623) 377-4737

Specialties & licenses 3

Addresses

Locations

Practitioners 1

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.

• Alan P Ketterling, MA, LMFT

  • Marriage & Family Therapist
  • Glendale, AZ
  • NPI 1306333133
  NPD Authorized official

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

{
    "created_epoch": "1695945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1518747484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18450 W BROOKWOOD DR",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853386476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5902 W CACTUS RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041710",
            "telephone_number": "623-377-4738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 E Shea Blvd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850286024",
            "country_code": "US",
            "telephone_number": "623-377-4737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOMENTUM COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-29",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "KETTERLING",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-377-4737"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Glendale, AZ
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.