Healthcare Provider Details

I. General information

NPI: 1477259703
Provider Name (Legal Business Name): STEVEN DANA MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 BUCKSKIN CANYON RD
HEBER AZ
85928-9801
US

IV. Provider business mailing address

1021 S RIDGELINE DR
SHOW LOW AZ
85901-9589
US

V. Phone/Fax

Practice location:
  • Phone: 928-535-4622
  • Fax: 928-535-5146
Mailing address:
  • Phone: 928-242-8229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6670810
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: