Healthcare Provider Details

I. General information

NPI: 1558285387
Provider Name (Legal Business Name): BLISSFUL MOMENT COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 S HIGLEY RD STE 125
MESA AZ
85206-3450
US

IV. Provider business mailing address

4539 N 22ND ST STE N
PHOENIX AZ
85016-4639
US

V. Phone/Fax

Practice location:
  • Phone: 480-628-7803
  • Fax:
Mailing address:
  • Phone: 480-628-7803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: STACY BLISS LEFEBVRE
Title or Position: OWNER
Credential: LPC
Phone: 480-628-7803