Healthcare Provider Details

I. General information

NPI: 1104972090
Provider Name (Legal Business Name): DESERT BEHAVIORAL HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 N GILBERT RD STE 107
GILBERT AZ
85234-5812
US

IV. Provider business mailing address

207 N GILBERT RD STE 107
GILBERT AZ
85234-5812
US

V. Phone/Fax

Practice location:
  • Phone: 480-839-4620
  • Fax: 480-345-8282
Mailing address:
  • Phone: 480-839-4620
  • Fax: 480-345-8282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC 0362
License Number StateAZ

VIII. Authorized Official

Name: MRS. SANDRA A. TURSINI
Title or Position: OWNER
Credential: MC, LPC
Phone: 480-839-4620