NPI Code Detail JSON Logo

1104554237 NPI number — EAST VALLEY FAMILY THERAPY

NPI Number: 1104554237
Health Care Provider/Practitioner: EAST VALLEY FAMILY THERAPY

Information about “1104554237” NPI (EAST VALLEY FAMILY THERAPY) exists in 1104554237 in HTML format HTML  |  1104554237 in plain Text format TXT  |  1104554237 in PDF (Portable Document Format) PDF  |  1104554237 in an XML format XML  formats.

NPI Number : 1104554237 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104554237",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "EAST VALLEY FAMILY THERAPY",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "21321 E OCOTILLO RD STE 132",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "QUEEN CREEK",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85142-5995",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "602-759-0512",
    "MailingAddressFaxNumber": "602-584-7290",
    "FirstLinePracticeLocationAddress": "21321 E OCOTILLO RD STE 132",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "QUEEN CREEK",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85142-5995",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "602-759-0512",
    "PracticeLocationAddressFaxNumber": "602-584-7290",
    "EnumerationDate": "08/08/2022",
    "LastUpdateDate": "08/08/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HARROP",
    "AuthorizedOfficialFirstName": "JONATHAN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LMFT",
    "AuthorizedOfficialTelephoneNumber": "602-759-0512",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QM0850X",
          "TaxonomyName": "Adult Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0855X",
          "TaxonomyName": "Adolescent and Children Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0801X",
          "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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