NPIMap

Organization Active NPI

Joven Health, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Gilbert, AZ
National Provider Identifier
1790393197
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
JOVEN HEALTH, LLC
Practice address
3635 E Larson LN
Gilbert, AZ 85295-7229
Phone
(734) 486-5579
NPI assigned
Jul 21, 2020
Organization subpart
Yes
Parent organization
SOCIAL FABRIC, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Authorized official

Name
Tyler Lee McCord, LMSWNPI 1285242677
Title
Director of Business Development
Phone
(734) 486-5579

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

3635 E Larson LN
Gilbert, AZ 85295-7229

Mailing address

3854 S Halifax St
Aurora, CO 80013-3973
Phone (734) 486-5579

Other names 1

  • Joven Health, LLC Doing business as

National Provider Directory

National Provider Directory
Part of
Joven Health LLC

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1790393197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3854 S HALIFAX ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800133973",
            "telephone_number": "734-486-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 E LARSON LN",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852957229",
            "telephone_number": "734-486-5579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOVEN HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOCIAL FABRIC, LLC",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "MCCORD",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "734-486-5579",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joven Health, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Joven Health, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.