Healthcare Provider Details

I. General information

NPI: 1497691638
Provider Name (Legal Business Name): BESPOKEN TALK THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16815 S DESERT FOOTHILLS PKWY STE 140
PHOENIX AZ
85048-8465
US

IV. Provider business mailing address

16815 S DESERT FOOTHILLS PKWY STE 140
PHOENIX AZ
85048-8465
US

V. Phone/Fax

Practice location:
  • Phone: 480-250-1848
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DANA BOWERBANK
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 480-250-1848