Healthcare Provider Details

I. General information

NPI: 1689634917
Provider Name (Legal Business Name): THOMAS KIRSCH LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3807 N 7TH ST
PHOENIX AZ
85014-5005
US

IV. Provider business mailing address

5151 E GUADALUPE RD APT 2134
PHOENIX AZ
85044-7730
US

V. Phone/Fax

Practice location:
  • Phone: 205-512-0062
  • Fax: --
Mailing address:
  • Phone: 480-739-7580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-24985
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: