NPIMap

Organization Active NPI

Empact-Suicide Prevention Center

  • Community/Behavioral Health Agency
  • Tempe, AZ
National Provider Identifier
1609071646
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
BH-4062 Issued in AZ
Legal business name
EMPACT-SUICIDE PREVENTION CENTER
Practice address
618 S. Madison Drive
Tempe, AZ 85281-7248
Phone
(480) 784-1514
Fax
(480) 967-3528
NPI assigned
Jun 19, 2007
Last updated
Feb 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Authorized official

Name
Liz Montano
Title
Credentialing Coordinator
Phone
(480) 784-1514

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X BH 373 AZ
Community/Behavioral Health Agency 251S00000X BH-4062 AZ Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

618 S. Madison Drive
Tempe, AZ 85281-7248

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
971673MedicaidAZ

National Provider Directory

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

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614038400000",
    "number": "1609071646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 S. MADISON DRIVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852817248",
            "telephone_number": "480-784-1514",
            "fax_number": "480-967-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 S. MADISON DRIVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852817248",
            "telephone_number": "480-784-1514",
            "fax_number": "480-967-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPACT-SUICIDE PREVENTION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A",
        "authorized_official_last_name": "MONTANO",
        "authorized_official_first_name": "LIZ",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "480-784-1514"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH 373",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-4062",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "971673",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Feb 23, 2021; 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.