PHOENIX WELLNESS CENTER LLC NPI 1720572043

NPI Information

NPI: 1720572043
Provider Name: PHOENIX WELLNESS CENTER LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
2060 W WHISPERING WIND DR STE 270
PHOENIX, AZ
ZIP 85085
Phone: (480) 653-8434
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PHOENIX WELLNESS CENTER LLC is a mental health counselor in Phoenix, AZ. PHOENIX WELLNESS CENTER LLC NPI is 1720572043. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2060 W WHISPERING WIND DR STE 270
PHOENIX, AZ
ZIP 85085
Phone: (480) 653-8434
Fax: (623) 258-4077

The provider's authorized official is Tonya Kinnaman .
The authorized official title is Administrator and has the following contact phone number (480) 653-8434.

The enumeration date for this NPI number is 6/20/2018 and was last updated on 6/21/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101Y00000X	Counselor		No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
3	101YM0800X	Counselor	Mental Health	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	OTC8779	OTHER	ARIZONA	OUTPATIENT TREATMENT CENTER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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