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PROFESSIONAL PSYCHOLOGY ASSOCIATES PC NPI 1801016878


NPI Information

NPI: 1801016878
Provider Name: PROFESSIONAL PSYCHOLOGY ASSOCIATES, PC

Doing Business As: CENTER FOR LIFESTYLE CHANGE

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 03D2203247

Address:
4222 E CAMELBACK RD
SUITE H230
PHOENIX, AZ
ZIP 85018
Phone: (602) 852-0911
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PROFESSIONAL PSYCHOLOGY ASSOCIATES, PC is a rehabilitation and substance use disorder clinic center in Phoenix, AZ. PROFESSIONAL PSYCHOLOGY ASSOCIATES, PC NPI is 1801016878. The provider is registered as an organization entity type.
The provider Is Doing Business As Center For Lifestyle Change.

The provider's business location address is:

4222 E CAMELBACK RD
SUITE H230
PHOENIX, AZ
ZIP 85018-745
Phone: (602) 852-0911
Fax: (602) 852-0632

The provider's authorized official is Phillip D Lett .
The authorized official title is Administrator/president and has the following contact phone number (602) 852-0911.

The CLIA number assigned to this NPI record is 03D2203247 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/1/2007 and was last updated on 6/12/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderBH934ARIZONAYes

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: 4/28/2024

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