NPIMap

Organization Active NPI

Family Tree Therapy Services LLC

  • Professional Counselor
  • Phoenix, AZ
National Provider Identifier
1689131054
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
FAMILY TREE THERAPY SERVICES LLC
Practice address
4425 E Agave Rd Ste 106
Phoenix, AZ 85044-0620
Phone
(480) 248-5338
NPI assigned
Feb 21, 2019
Last updated
Nov 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Authorized official

Name
Dalisa Jimenez, LPCNPI 1407346778
Title
Owner
Phone
(954) 253-8559

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

4425 E Agave Rd Ste 106
Phoenix, AZ 85044-0620

Mailing address

4425 E Agave Rd Ste 106
Phoenix, AZ 85044-0620

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dalisa@familytreetherapyservices.com Direct

National Provider Directory

National Provider Directory

Locations

4425 E Agave Rd
Ste 106
Phoenix, AZ 85044
Phone (480) 363-7431

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": "1550707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572566400000",
    "number": "1689131054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 E AGAVE RD STE 106",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850440620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 E AGAVE RD STE 106",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850440620",
            "telephone_number": "480-248-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY TREE THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-21",
        "last_updated": "2019-11-01",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "DALISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-253-8559",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dalisa@familytreetherapyservices.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4425 E Agave Rd Ste 106",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850440620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; 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.