Healthcare Provider Details

I. General information

NPI: 1558765420
Provider Name (Legal Business Name): SPRINGBOARD COUNSELING SERIVCES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2014
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11624 E SHEA BLVD
SCOTTSDALE AZ
85259-5111
US

IV. Provider business mailing address

11624 E SHEA BLVD
SCOTTSDALE AZ
85259-5111
US

V. Phone/Fax

Practice location:
  • Phone: 888-672-2120
  • Fax: 888-672-2120
Mailing address:
  • Phone: 602-694-9643
  • Fax: 888-672-2120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMED5851
License Number StateAZ

VIII. Authorized Official

Name: ANDREA STINER
Title or Position: BILING DIRECTOR
Credential:
Phone: 602-694-9643