Self

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LPC 14499 Issued in AZ

Legal business name

SELF

Practice address

5010 E Shea Blvd Ste D202
Scottsdale, AZ 85254-4570

Phone

(602) 569-4328

Fax

(602) 569-4378

NPI assigned

Dec 2, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Michael Raimondi, LPC 14499/LISAC 1158

Title

Therapist

Phone

(602) 569-4328

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1912372822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 E SHEA BLVD STE D202",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852544570",
            "telephone_number": "602-569-4328",
            "fax_number": "602-569-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 E SHEA BLVD STE D202",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852544570",
            "telephone_number": "602-569-4328",
            "fax_number": "602-569-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-02",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "RAIMONDI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "602-569-4328",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC 14499/LISAC 1158"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "LPC 14499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Scottsdale, AZ
• Providers in Scottsdale, 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 2, 2015; 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.