Healthcare Provider Details

I. General information

NPI: 1609474253
Provider Name (Legal Business Name): WINTER GROESCHL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2020
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 E MISSOURI AVE STE C160
PHOENIX AZ
85014-2458
US

IV. Provider business mailing address

1440 E MISSOURI AVE STE C160
PHOENIX AZ
85014-2458
US

V. Phone/Fax

Practice location:
  • Phone: 602-878-8142
  • Fax: 602-563-8150
Mailing address:
  • Phone: 602-878-8142
  • Fax: 602-563-8150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-20131
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: