Healthcare Provider Details

I. General information

NPI: 1336812544
Provider Name (Legal Business Name): WARNER PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 E CHANDLER BLVD STE 107
PHOENIX AZ
85048-6280
US

IV. Provider business mailing address

PO BOX 8563
PHOENIX AZ
85066-8563
US

V. Phone/Fax

Practice location:
  • Phone: 602-489-8754
  • Fax:
Mailing address:
  • Phone: 602-489-8754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: CHERYL B WARNER
Title or Position: LICENSED PSYCHOLOGIST
Credential: PHD
Phone: 602-489-8754