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NPI Code Detail

MEDICARE: RESILIENT STAR COUNSELING AND WELLNESS, LLC

MEDICARE: RESILIENT STAR COUNSELING AND WELLNESS, 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1942153978
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESILIENT STAR COUNSELING AND WELLNESS, LLC
Provider Business Mailing Address
First Line : 15150 W PARK PL # 2034
Second Line :
City : GOODYEAR
State : AZ
Zip : 85395-2385
Country : US
Telephone Number : 623-759-0290
Fax Number :
Provider Business Practice Location Address
First Line : 15150 W PARK PL # 2034
Second Line :
City : GOODYEAR
State : AZ
Zip : 85395-2385
Country : US
Telephone Number : 623-759-0290
Fax Number :
Authorized Official
Title or Position : CLINICIAN/OWNER
Name : MS. TARA JONES
Credential : MS, LPC
Telephone Number : 623-262-7620
Provider Enumeration Date : 02/18/2026
Last Update Date : 02/18/2026

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