Healthcare Provider Details

I. General information

NPI: 1427976273
Provider Name (Legal Business Name): SELFCARE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

3035 E SOUTHERN AVE
PHOENIX AZ
85040-3714
US

IV. Provider business mailing address

9546 W KINGMAN ST
TOLLESON AZ
85353-8557
US

V. Phone/Fax

Practice location:
  • Phone: 602-741-3180
  • Fax:
Mailing address:
  • Phone: 602-741-3180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. LAKESHA ANN DUNCAN
Title or Position: LPC
Credential: LPC
Phone: 602-741-3180