NPIMap

Organization Active NPI

Statt Counseling Services, PLLC

Doing business as Affinity Counseling Center

  • Professional Counselor
  • Tucson, AZ
National Provider Identifier
1922542174
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
STATT COUNSELING SERVICES, PLLC
Doing business as
Affinity Counseling Center
Practice address
3295 W Ina Rd Ste 125
Tucson, AZ 85741-2195
Phone
(520) 257-1168
Fax
(520) 306-4861
NPI assigned
Dec 7, 2016
Last updated
May 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Authorized official

Name
Jonathan Statt, LMFTNPI 1447570197
Title
Owner
Phone
(520) 257-1168

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

3295 W Ina Rd Ste 125
Tucson, AZ 85741-2195

Mailing address

PO Box 89784
Tucson, AZ 85752-9784
Phone (520) 257-1168

Other names 1

  • Affinity Counseling Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180221001006 AZ Part B Supplier - Clinic/Group Practice 4880955525 Receives reassigned benefits from 12 practitioners
Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory

Locations

2295 W Magee Rd
Unit 105
Tucson, AZ 85742
Phone 5202571168 ext. 713

3295 W Ina Rd
Ste 125
Tucson, AZ 85741
Phone (520) 257-1168

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525651200000",
    "number": "1922542174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 89784",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857529784",
            "telephone_number": "520-257-1168",
            "fax_number": "520-306-4861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3295 W INA RD STE 125",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857412195",
            "telephone_number": "520-257-1168",
            "fax_number": "520-306-4861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATT COUNSELING SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-07",
        "last_updated": "2018-05-07",
        "status": "A",
        "authorized_official_last_name": "STATT",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-257-1168",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affinity Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Affinity Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.