Motherland Counseling, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MOTHERLAND COUNSELING, LLC

Practice address

3161 W Cheryl Dr Apt A16
Phoenix, AZ 85051-2557

Phone

(520) 331-5287

NPI assigned

Aug 9, 2022

Organization subpart

No

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

Authorized official

Name

Jimmy MuyumbuNPI 1568190429

Title

Owner

Phone

(520) 331-5287

Specialties & licenses 5

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jimmy Muyumbu

  • Behavior Technician
  • Phoenix, AZ
  • NPI 1568190429
  NPD Authorized official

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1720716608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10835 N 25TH AVE STE 125",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293461",
            "telephone_number": "520-331-5287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3161 W CHERYL DR APT A16",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850512557",
            "telephone_number": "520-331-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOTHERLAND COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-09",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "MUYUMBU",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-331-5287"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "chuchumuyumbu@gmail.com",
            "affiliation": "N",
            "address_1": "10835 N 25th Ave Ste 125",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850293461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community/Behavioral Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.