Healthcare Provider Details
I. General information
NPI: 1992999189
Provider Name (Legal Business Name): TRUE CARE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2007
Last Update Date: 01/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7155 WEST CAMPO BELLO DRIVE SUITE B160
GLENDALE AZ
85308-8554
US
IV. Provider business mailing address
7155 WEST CAMPO BELLO DRIVE SUITE B 160
GLENDALE AZ
85308-8554
US
V. Phone/Fax
- Phone: 623-533-5138
- Fax: 623-533-4271
- Phone: 623-533-5138
- Fax: 623-533-4271
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | 4055 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 1356 |
| License Number State | AZ |
VIII. Authorized Official
Name:
TRUDY
MARIE
SONCRANT
Title or Position: OWNER
Credential: MSW,LCSW,LISAC
Phone: 602-377-8324