Healthcare Provider Details

I. General information

NPI: 1598697328
Provider Name (Legal Business Name): PURE WELLNESS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21321 E OCOTILLO RD STE 113
QUEEN CREEK AZ
85142-5994
US

IV. Provider business mailing address

21321 E OCOTILLO RD STE 113
QUEEN CREEK AZ
85142-5994
US

V. Phone/Fax

Practice location:
  • Phone: 480-448-9985
  • Fax: 480-739-0409
Mailing address:
  • Phone: 480-448-9985
  • Fax: 480-739-0409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JILL DORENBUSH
Title or Position: BUSINESS OWNER/THERAPIST
Credential: LPC
Phone: 480-448-9985