Academic & Behavioral Center LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-2746 Issued in AZ

Legal business name

ACADEMIC & BEHAVIORAL CENTER LLC

Practice address

1122 N Olsen Ave
Tucson, AZ 85719-4717

Phone

(520) 323-9835

Fax

(520) 327-2342

NPI assigned

Apr 1, 2011

Organization subpart

No

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

Authorized official

Name

David M Bynes, LCSW

Title

Director

Phone

(520) 323-9835

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301616000000",
    "number": "1861781650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 E BROADWAY BLVD",
            "address_2": "#315",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113704",
            "telephone_number": "520-323-9835",
            "fax_number": "520-327-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 N OLSEN AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194717",
            "telephone_number": "520-323-9835",
            "fax_number": "520-327-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMIC & BEHAVIORAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-04-01",
        "status": "A",
        "authorized_official_last_name": "BYNES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "520-323-9835",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-2746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE IDENTIFIER",
            "identifier": "Z100597",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; 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.