Family Christian Counseling Center of Phoenix

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC2089 Issued in AZ

Legal business name

FAMILY CHRISTIAN COUNSELING CENTER OF PHOENIX

Practice address

1300 E Missouri Ave
Suite B200
Phoenix, AZ 85014-2362

Phone

(602) 320-7955

NPI assigned

Oct 25, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Deborah L Pettitt, LPC

Title

Director

Phone

(602) 320-7955

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287964800000",
    "number": "1720388796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14244 N 50TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852542868",
            "telephone_number": "602-320-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E MISSOURI AVE",
            "address_2": "SUITE B200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142362",
            "telephone_number": "602-320-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CHRISTIAN COUNSELING CENTER OF PHOENIX",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A",
        "authorized_official_last_name": "PETTITT",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "602-320-7955",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC2089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.