Healthcare Provider Details

I. General information

NPI: 1467225763
Provider Name (Legal Business Name): ARRANGE YOUR CHANGE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23804 S 231ST WAY
QUEEN CREEK AZ
85142-1548
US

IV. Provider business mailing address

23804 S 231ST WAY
QUEEN CREEK AZ
85142-1548
US

V. Phone/Fax

Practice location:
  • Phone: 702-420-8064
  • Fax:
Mailing address:
  • Phone: 702-420-8064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DARRIAN M MCKIERNAN
Title or Position: OWNER
Credential: LMFT
Phone: 702-420-8064