MEDICARE: DARLENE SUMMERS LPC

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	101YP2500X	Professional Counselor	LPC-12996	AZ

General Provider Information

NPI Number	:	1922266022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARLENE SUMMERS LPC

Provider Business Mailing Address
First Line	:	17505 N 79TH AVE
Second Line	:	SUITE 311
City	:	GLENDALE
State	:	AZ
Zip	:	85308-8725
Country	:	US
Telephone Number	:	602-684-5234
Fax Number	:

Provider Business Practice Location Address
First Line	:	17505 N 79TH AVE
Second Line	:	SUITE 311
City	:	GLENDALE
State	:	AZ
Zip	:	85308-8725
Country	:	US
Telephone Number	:	602-684-5234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	01/14/2011

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Directions to “ DARLENE SUMMERS LPC” Practice Location

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