Healthcare Provider Details

I. General information

NPI: 1407216518
Provider Name (Legal Business Name): ARCADIA COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2016
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 N 44TH ST STE 120
PHOENIX AZ
85018-6060
US

IV. Provider business mailing address

3610 N 44TH ST STE 120
PHOENIX AZ
85018-6060
US

V. Phone/Fax

Practice location:
  • Phone: 602-218-6901
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-15962
License Number StateAZ

VIII. Authorized Official

Name: LAURA T GREENWOOD
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential:
Phone: 602-218-6901