Healthcare Provider Details

I. General information

NPI: 1629731708
Provider Name (Legal Business Name): VALLEY THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2021
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2266 S DOBSON RD STE 200
MESA AZ
85202-6412
US

IV. Provider business mailing address

2238 S CANTON
MESA AZ
85202-6617
US

V. Phone/Fax

Practice location:
  • Phone: 602-899-3773
  • Fax:
Mailing address:
  • Phone: 480-371-7307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. SANJAY MATTHEW JOSEPH KESTNER
Title or Position: COUNSELOR
Credential: MC, LPC
Phone: 480-371-7307