Mary Colburn

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

13640 Issued in AZ

Practice address

2632 E Thomas Rd Ste 101
Phoenix, AZ 85016-8220

Phone

(602) 957-2507

Fax

(602) 957-2510

NPI assigned

May 28, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southwest Behavioral Health

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
  • NPI 1023023603
  NPD (past)
• Southwest Behavioral Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1407165392
  NPD (past)

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1558740183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122331",
            "telephone_number": "602-257-9339",
            "fax_number": "602-265-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 E THOMAS RD STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168220",
            "telephone_number": "602-957-2507",
            "fax_number": "602-957-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBURN",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "13640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominique Yvette Colbert
• George Colbert
• Randi Danielle Colbert, DO
• Elizabeth Rose Colburn, MS, ATC
• Luc Alexander Colburn, MD
• Chelsea Louise Colby, AGACNP-BC
• Matthew John Colby, D.C.
• Thomas V Colby, M.D.
• Elizabeth Roush Coldiron, MSW
• Alison M. Cole, DNP, APRN, AGNP-C

• Professional Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; 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.