Healthcare Provider Details

I. General information

NPI: 1124965777
Provider Name (Legal Business Name): CONNECTIONS COUNSELING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4539 N 22ND ST # 6284
PHOENIX AZ
85016-4639
US

IV. Provider business mailing address

4539 N 22ND ST # 6284
PHOENIX AZ
85016-4639
US

V. Phone/Fax

Practice location:
  • Phone: 623-341-7057
  • Fax:
Mailing address:
  • Phone: 623-341-7057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JASMINE SIRAKIS
Title or Position: CLINICAL THERAPIST AND SUPERVISOR
Credential: LMFT-15360
Phone: 623-341-7057