Healthcare Provider Details

I. General information

NPI: 1003711391
Provider Name (Legal Business Name): DESERT IRIS COUNSELING AZ PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6424 E GREENWAY PKWY
SCOTTSDALE AZ
85254
US

IV. Provider business mailing address

13236 N 7TH STREET SUITE 4 PMB 358
PHOENIX AZ
85022
US

V. Phone/Fax

Practice location:
  • Phone: 928-832-3824
  • Fax:
Mailing address:
  • Phone: 928-832-3824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DOROTHY FAUST DAVIS
Title or Position: SOLE MEMBER
Credential: LPC
Phone: 928-832-3824