Healthcare Provider Details

I. General information

NPI: 1922590397
Provider Name (Legal Business Name): BARBARA J PLOURD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2018
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7155 W CAMPO BELLO DR STE B110
GLENDALE AZ
85308-8594
US

IV. Provider business mailing address

7155 W CAMPO BELLO DR STE B110
GLENDALE AZ
85308-8594
US

V. Phone/Fax

Practice location:
  • Phone: 623-218-6030
  • Fax: 623-218-6032
Mailing address:
  • Phone: 623-218-6030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-17294
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: