Healthcare Provider Details

I. General information

NPI: 1912131764
Provider Name (Legal Business Name): CRISTI ANN SOIYA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2009
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15333 N PIMA RD STE 305
SCOTTSDALE AZ
85260-2717
US

IV. Provider business mailing address

15333 N PIMA RD STE 305
SCOTTSDALE AZ
85260-2717
US

V. Phone/Fax

Practice location:
  • Phone: 602-920-9962
  • Fax: 844-284-3519
Mailing address:
  • Phone: 602-920-9962
  • Fax: 844-284-3519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCP 60233412
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLISAC 11868
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH 60233395
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC 13233
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: