Healthcare Provider Details

I. General information

NPI: 1164318499
Provider Name (Legal Business Name): THERAPY NEST, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E GURLEY ST STE A
PRESCOTT AZ
86301-3246
US

IV. Provider business mailing address

1086 E WAGON WHEEL DR
PRESCOTT AZ
86303-8236
US

V. Phone/Fax

Practice location:
  • Phone: 928-224-9109
  • Fax:
Mailing address:
  • Phone: 928-224-9109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: SHERRINA JOHNSON
Title or Position: OWNER
Credential: MS, LMFT
Phone: 928-224-9109