Healthcare Provider Details

I. General information

NPI: 1972132231
Provider Name (Legal Business Name): BUILDING BLOCKS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N OCOTILLO DR BLDG 1
APACHE JUNCTION AZ
85120-3740
US

IV. Provider business mailing address

3030 N CENTRAL AVE STE 506
PHOENIX AZ
85012-2825
US

V. Phone/Fax

Practice location:
  • Phone: 602-626-8112
  • Fax:
Mailing address:
  • Phone: 602-626-8112
  • Fax: 602-975-2194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: VERN JOHNSON
Title or Position: OWNER
Credential:
Phone: 602-626-8112