Healthcare Provider Details

I. General information

NPI: 1447179015
Provider Name (Legal Business Name): FLAGSTAFF PSYCHOLOGY AND COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 E TERRACE AVE STE A
FLAGSTAFF AZ
86001-5267
US

IV. Provider business mailing address

119 E TERRACE AVE STE A
FLAGSTAFF AZ
86001-5267
US

V. Phone/Fax

Practice location:
  • Phone: 602-478-9957
  • Fax:
Mailing address:
  • Phone: 602-478-9957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ROXANNE HAIT
Title or Position: OWNER/CLINICAL ADMINISTRATOR
Credential: PSYD, LP
Phone: 602-478-9957