Healthcare Provider Details

I. General information

NPI: 1558878934
Provider Name (Legal Business Name): ASPEN BEHAVIORAL CONSULTING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2018
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2487 S GILBERT RD STE 106-153
GILBERT AZ
85295-2807
US

IV. Provider business mailing address

2487 S GILBERT RD STE 106-153
GILBERT AZ
85295-8899
US

V. Phone/Fax

Practice location:
  • Phone: 480-694-9958
  • Fax:
Mailing address:
  • Phone: 480-744-5286
  • Fax: 480-675-4538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTINE NICOLE MOONEY
Title or Position: CO-OWNER
Credential: BCBA, LBA, IBA
Phone: 480-744-5286