Healthcare Provider Details

I. General information

NPI: 1669301263
Provider Name (Legal Business Name): SLR MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 E BROADWAY RD STE 31-32
TEMPE AZ
85282-1879
US

IV. Provider business mailing address

6610 E UNIVERSITY DR UNIT 25
MESA AZ
85205-7611
US

V. Phone/Fax

Practice location:
  • Phone: 785-819-6514
  • Fax:
Mailing address:
  • Phone: 785-819-6514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MISS SHELBY ROUSE
Title or Position: OWNER
Credential: LPC
Phone: 785-819-6514