MEDICARE: PHOENIX THERAPISTS HUB COUNSELING GROUP 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	103TP2701X	Group Psychotherapy Psychologist

General Provider Information

NPI Number	:	1922965318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHOENIX THERAPISTS HUB COUNSELING GROUP LLC

Provider Business Mailing Address
First Line	:	16601 N 40TH ST STE 216
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-3354
Country	:	US
Telephone Number	:	480-788-8466
Fax Number	:	480-591-9426

Provider Business Practice Location Address
First Line	:	16601 N 40TH ST STE 216
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-3354
Country	:	US
Telephone Number	:	480-788-8466
Fax Number	:	480-591-9426

Authorized Official
Title or Position	:	OWNER
Name	:	JUSTIN JORY
Credential	:	MHA
Telephone Number	:	480-788-8466

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

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