Active NPI
Joel Childs
- Child Mental Illness Respite Care
- Hereford, AZ
National Provider Identifier
1649536251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child Mental Illness Respite Care
- License
- 3852
- Practice address
- 9367 Chippewa Drive
Hereford, AZ 85615 - Phone
- (520) 378-9415
- NPI assigned
- Apr 9, 2012
- Last updated
- Apr 9, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child Mental Illness Respite Care | 385HR2055X | 3852 | AZ | Primary |
Addresses
Primary practice location
9367 Chippewa Drive
Hereford, AZ 85615
Mailing address
9367 Chippewa Drive
Hereford, AZ 85615
Phone (520) 378-9415
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3852 | AZ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333929600000",
"number": "1649536251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9367 CHIPPEWA DRIVE",
"city": "HEREFORD",
"state": "AZ",
"postal_code": "85615",
"telephone_number": "520-378-9415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9367 CHIPPEWA DRIVE",
"city": "HEREFORD",
"state": "AZ",
"postal_code": "85615",
"telephone_number": "520-378-9415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDS",
"first_name": "JOEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-09",
"last_updated": "2012-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "385HR2055X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Mental Illness, Child",
"state": "AZ",
"license": "3852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hereford, AZ
- Leisa Diane Wilson Boyer, M.A.
- Scott Burton
- Michelle Lynne Capers, RN
- Anne M Castello, BCBA, M.ED., BCBA
- Kelly Michelle Ceniceros, R.N.
- Ear-Central, PLLC
- Eldercare for Life (Thoroughcare Rehabilitation)
- Eldercare for Life Inc (Windmill Ranch)
- Eldercare for Life Inc (Thoroughcare Home Health)
- Jo Ana S. Fields, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.