Individual provider Active NPI

Maryjoy C Kearns

  • Mental Health Counselor
  • Glendale, AZ
National Provider Identifier
1740814664
Registry record updated Feb 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LAC-17598 Issued in AZ
Practice address
7400 W Arrowhead Clubhouse Dr Apt 2036
Glendale, AZ 85308-8825
Phone
(480) 677-9211
NPI assigned
Feb 29, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LAC-17598 AZ Primary

Addresses

Primary practice location

7400 W Arrowhead Clubhouse Dr Apt 2036
Glendale, AZ 85308-8825

Mailing address

7400 W Arrowhead Clubhouse Dr Apt 2036
Glendale, AZ 85308-8825
Phone (480) 677-9211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LAC-17598AZMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1582934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582934400000",
    "number": "1740814664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 W ARROWHEAD CLUBHOUSE DR APT 2036",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088825",
            "telephone_number": "480-677-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 W ARROWHEAD CLUBHOUSE DR APT 2036",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088825",
            "telephone_number": "480-677-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARNS",
        "first_name": "MARYJOY",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-29",
        "last_updated": "2020-02-29",
        "certification_date": "2020-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-17598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2020; 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.