Healthcare Provider Details

I. General information

NPI: 1619574134
Provider Name (Legal Business Name): STREETLIGHTUSA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6805 N 81ST AVE BLDG B
GLENDALE AZ
85303-2807
US

IV. Provider business mailing address

8380 W EMILE ZOLA AVE # 6178
PEORIA AZ
85381-9998
US

V. Phone/Fax

Practice location:
  • Phone: 623-435-0900
  • Fax:
Mailing address:
  • Phone: 623-435-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SKYE STEELE
Title or Position: CEO
Credential:
Phone: 623-435-0900