East Valley PTSD Counseling

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EAST VALLEY PTSD COUNSELING

Practice address

4140 E Baseline Rd Ste 101
Mesa, AZ 85206-4413

Phone

(480) 789-9015

Fax

(877) 345-1938

NPI assigned

Sep 29, 2021

Last updated

Sep 29, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathryn Tiffany, LPCNPI 1487291993

Title

Therapist

Phone

(480) 789-9015

Specialties & licenses 1

Addresses

Electronic endpoints 1

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.

• Kathryn Tiffany

  • Mental Health Counselor
  • Mesa, AZ
  • NPI 1487291993
  NPD Authorized official

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1689346561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 E BASELINE RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064413",
            "telephone_number": "480-789-9015",
            "fax_number": "877-345-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 E BASELINE RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064413",
            "telephone_number": "480-789-9015",
            "fax_number": "877-345-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VALLEY PTSD COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "TIFFANY",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "480-789-9015",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Fax",
            "affiliation": "N",
            "endpointDescription": "877-345-1938",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Client information for collaboration of care",
            "address_1": "4140 E Baseline Rd Ste 101",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852064413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.