MEDICARE: ANTHEM COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1811854193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTHEM COUNSELING, LLC

Provider Business Mailing Address
First Line	:	39506 N DAISY MOUNTAIN DR STE 122-187
Second Line	:
City	:	ANTHEM
State	:	AZ
Zip	:	85086-1663
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	39506 N DAISY MOUNTAIN DR STE 122-187
Second Line	:
City	:	ANTHEM
State	:	AZ
Zip	:	85086-1663
Country	:	US
Telephone Number	:	928-683-1753
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	CHRISTINE COLON
Credential	:
Telephone Number	:	928-683-1753

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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