Healthcare Provider Details

I. General information

NPI: 1407585789
Provider Name (Legal Business Name): BEN DAVID ORLANDO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 PANORAMA BLVD
SEDONA AZ
86336-5504
US

IV. Provider business mailing address

460 PANORAMA BLVD
SEDONA AZ
86336-5504
US

V. Phone/Fax

Practice location:
  • Phone: 202-808-4543
  • Fax:
Mailing address:
  • Phone: 202-808-4543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-25054.
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704014882
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: