Healthcare Provider Details

I. General information

NPI: 1568567634
Provider Name (Legal Business Name): ERIC ROSS VOIGTMAN MS, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18205 N 51ST AVE STE 109
GLENDALE AZ
85308-1491
US

IV. Provider business mailing address

2146 E CLAIRE DR
PHOENIX AZ
85022-4151
US

V. Phone/Fax

Practice location:
  • Phone: 602-697-2505
  • Fax: 855-595-2710
Mailing address:
  • Phone: 602-697-2505
  • Fax: 602-302-7925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10074
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC10074
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: