THE POTTER'S HOUSE SUBSTANCE ABUSE CENTER (NPI# 1225147960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225147960 |
| Entity Type | Organization |
| Organization Name | THE POTTER'S HOUSE SUBSTANCE ABUSE CENTER |
| Practice Address |
1717 W Northern Ave Ste 101 Phoenix AZ 85021-5400 |
| Practice Telephone | 6022549701 |
| Practice Fax Number | 6022520830 |
| Mailing Telephone | 6022549701 |
| Mailing Fax Number | 6022520830 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2019-10-22 |
| Authorized Official Name | MS. SHEENA ROSETTE JONES (VICE PRESIDENT) |
| Authorized Official Telephone | 6022549701 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 251S00000X | Community/Behavioral Health | BH3520 | AZ | Agencies |
| N | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
LISAC-10784 | AZ | Ambulatory Health Care Facilities |
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 004477 | 05 | |
| AZ | NPI | 1225147960 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043630320 | The Potter's House Substance Abuse Center | Counselor | 4220 N 20th Ave, Suite 100, Phoenix, AZ 85015-5101 | 2014-04-24 |
| Street Address |
1717 W NORTHERN AVE STE 101 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85021-5400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362535 | Robert Daughenbaugh | Counselor | 1717 W Northern Ave Ste 101, Phoenix, AZ 85021-5400 | 2020-10-02 |
| 1083170096 | Tina M Argueta | Counselor | 1717 W Northern Ave Ste 101, Phoenix, AZ 85021-5400 | 2019-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679173181 | Jill M Robinson | Social Worker | 8804 N. 23rd Ave, Bldg. A Ste. A01-a02, Phoenix, AZ 85021 | 2020-10-26 |
| 1528671013 | Sabrina Mcninch | Behavior Technician | 1200 W Dunlap Ave, Ste 100, Phoenix, AZ 85021 | 2020-08-25 |
| 1376169938 | Maricopa County Special Heallth Care District | Pharmacy | 2025 W Northern Ave, Phoenix, AZ 85021 | 2020-06-19 |
| 1841832664 | Madison Westby | Physical Therapist | 717 W Dunlap Ave # 100, Phoenix, AZ 85021 | 2019-10-14 |
| 1861967481 | Southwest Family Naturopathic Clinic Pllc | Naturopath | 1530 W Glendale Ave Suite 103, Phoenix, AZ 85021 | 2018-10-10 |
| 1184101461 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 8804 N 23rd Ave, Suite A01/a02, Phoenix, AZ 85021 | 2018-07-19 |
| 1568970150 | Alycia Ann Poloni | Occupational Therapist | 7129 N 23d Ave, Phoenix, AZ 85021 | 2018-01-17 |
| 1154839165 | Cyrus Professional Corporation | Dentist | 2401 W. Glendale Ave, Ste 102, Phoenix, AZ 85021 | 2018-01-12 |
| 1568980779 | Marla Jean Clay | Licensed Practical Nurse | 1717 W. Glendale Ave. Apt. 3011, Phoenix, AZ 85021 | 2017-09-07 |
| 1801325162 | Kaitlin King | Nurse Practitioner | 8824 N 9th Ave, Phoenix, AZ 85021 | 2017-06-08 |
| Find all providers in zip 85021 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384030 | Great Xpectations LLC | Community/Behavioral Health | 4014 W Christy Dr, Phoenix, AZ 85029-3958 | 2020-10-19 |
| 1386242295 | Mercy Cares LLC | Community/Behavioral Health | 2644 E Paradise Ln Apt D, Phoenix, AZ 85032-2945 | 2020-10-13 |
| 1124626080 | Beia's Families | Community/Behavioral Health | 3230 E Broadway Rd Ste C-235, Phoenix, AZ 85040-2873 | 2020-10-13 |
| 1518564442 | Infinity Groups Homes LLC | Community/Behavioral Health | 3523 E Everett Dr, Phoenix, AZ 85032-5136 | 2020-10-05 |
| 1013524230 | Civara Behavioral Health LLC | Community/Behavioral Health | 4010 W Cactus Rd, Phoenix, AZ 85029-2905 | 2020-10-01 |
| 1043827561 | Crossroads, Inc | Community/Behavioral Health | 2002 E Osborn Rd, Phoenix, AZ 85016-7236 | 2020-09-29 |
| 1043827025 | Guiding Steps Health Services, LLC | Community/Behavioral Health | 4926 E Mcdowell Rd, Phoenix, AZ 85008-4294 | 2020-09-24 |
| 1154931566 | Apex Transitional Housing Inc | Community/Behavioral Health | 13827 N 11th St, Phoenix, AZ 85022-4316 | 2020-08-01 |
| 1356959126 | Rock House Az, LLC | Community/Behavioral Health | 8650 N 35th Ave Ste 110, Phoenix, AZ 85051-3835 | 2020-07-17 |
| 1215554902 | Lydia Barton | Community/Behavioral Health | 1420 W Missouri Ave, Phoenix, AZ 85013-1919 | 2020-06-29 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.