Healthcare Provider Details

I. General information

NPI: 1437074168
Provider Name (Legal Business Name): CHRISTIAN COUNSELING CARE, PLLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34975 N NORTH VALLEY PKWY STE 152
PHOENIX AZ
85086-4032
US

IV. Provider business mailing address

30914 N 138TH AVE
PEORIA AZ
85383-8031
US

V. Phone/Fax

Practice location:
  • Phone: 480-670-4821
  • Fax:
Mailing address:
  • Phone: 623-853-6901
  • 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: TARA DORMAN
Title or Position: OWNER/COUNSELOR & SUPERVISOR
Credential: LPC
Phone: 480-670-4821