Healthcare Provider Details

I. General information

NPI: 1902255839
Provider Name (Legal Business Name): JOURNEYS COUNSELING CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2016
Last Update Date: 02/18/2024
Certification Date: 02/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6515 S RURAL RD STE 101
TEMPE AZ
85283-3880
US

IV. Provider business mailing address

6515 S RURAL RD STE 101
TEMPE AZ
85283-3880
US

V. Phone/Fax

Practice location:
  • Phone: 480-656-0500
  • Fax: 480-656-0770
Mailing address:
  • Phone: 480-656-0500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: ROXANE THORSTAD
Title or Position: LICENSED CLINICAL PSYCHOLOGIST
Credential:
Phone: 480-656-0500