NPIMap

Organization Active NPI

Shalom Behavioral Health, LLC

  • Addiction (Substance Use Disorder) Counselor
  • Glendale, AZ
National Provider Identifier
1619502192
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
SHALOM BEHAVIORAL HEALTH, LLC
Practice address
4449 W Keating Cir
Glendale, AZ 85308-3549
Phone
(602) 781-7025
NPI assigned
Mar 5, 2020
Last updated
Mar 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Authorized official

Name
Mr. James Thomal HarrisNPI 1487288213
Title
Ceo/Administrator
Phone
(602) 799-0030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

4449 W Keating Cir
Glendale, AZ 85308-3549

Mailing address

4449 W Keating Cir
Glendale, AZ 85308-3549
Phone (602) 781-7025

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Shalom1llc@gmail.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1583366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1619502192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4449 W KEATING CIR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083549",
            "telephone_number": "602-781-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4449 W KEATING CIR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083549",
            "telephone_number": "602-781-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "THOMAL",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "602-799-0030",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Shalom1llc@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Business URL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4449 W Keating Cir",
            "city": "Glendale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853083549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.