Scottsdale Providence Recovery Center

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

BH4837 Issued in AZ

Legal business name

SCOTTSDALE PROVIDENCE RECOVERY CENTER

Practice address

8889 E Via Linda
Scottsdale, AZ 85258-5420

Phone

(480) 284-7440

Fax

(480) 284-4178

NPI assigned

Mar 18, 2016

Organization subpart

No

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

Authorized official

Name

Daniel Joseph Nichols, LCSWNPI 1871944942

Title

Clinical Director

Phone

(480) 284-7440

Specialties & licenses 8

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Scottsdale Providence Recovery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Scottsdale Providence Recovery Center

  • Mental Illness Community Based Residential Treatment Facility
  • Scottsdale, AZ
  • NPI 1821705104
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Scottsdale Providence Recovery Center

  • Mental Illness Community Based Residential Treatment Facility
  • Scottsdale, AZ
  • NPI 1821705104
  NPPES parent name

Practitioners 1

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

• Daniel Nichols, LCSW

  • Clinical Social Worker
  • Scottsdale, AZ
  • NPI 1871944942
  NPD Authorized official

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579737600000",
    "number": "1740641612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8889 E VIA LINDA",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585420",
            "telephone_number": "480-284-7440",
            "fax_number": "480-284-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8889 E VIA LINDA",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585420",
            "telephone_number": "480-284-7440",
            "fax_number": "480-284-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTSDALE PROVIDENCE RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-18",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "480-284-7440",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "BH4837",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "BH4837",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "BH4837",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "AZ",
            "license": "BH4837",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "AZ",
            "license": "BH4837",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "AZ",
            "license": "BH4837",
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH4837",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AZ",
            "license": "BH4837",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.