Healthcare Provider Details

I. General information

NPI: 1487510574
Provider Name (Legal Business Name): YOUR SPACE COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2026
Last Update Date: 01/01/2026
Certification Date: 01/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 W ENCANTO BLVD UNIT 110
PHOENIX AZ
85003-1193
US

IV. Provider business mailing address

16 W ENCANTO BLVD UNIT 110
PHOENIX AZ
85003-1193
US

V. Phone/Fax

Practice location:
  • Phone: 480-253-9762
  • Fax:
Mailing address:
  • Phone: 480-253-9762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHANEN NORLIN
Title or Position: COUNSELOR
Credential: LPC
Phone: 480-253-9762