Healthcare Provider Details

I. General information

NPI: 1457918864
Provider Name (Legal Business Name): INTUITIVE HEALING COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 05/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3303 E BASELINE RD, BUILDING 5, SUITE 109
GILBERT AZ
85234
US

IV. Provider business mailing address

1244 E COMMERCE AVE
GILBERT AZ
85234
US

V. Phone/Fax

Practice location:
  • Phone: 480-534-6476
  • Fax:
Mailing address:
  • Phone: 480-534-6476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. JAN LAMOREAUX
Title or Position: THERAPIST, OWNER
Credential: MC, LISAC
Phone: 480-534-6476