Healthcare Provider Details

I. General information

NPI: 1568253417
Provider Name (Legal Business Name): TRUE MYTH COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10379 E CAPERCAILLIE ST
TUCSON AZ
85747-8971
US

IV. Provider business mailing address

10379 E CAPERCAILLIE ST
TUCSON AZ
85747-8971
US

V. Phone/Fax

Practice location:
  • Phone: 520-230-5626
  • Fax:
Mailing address:
  • Phone: 520-230-5626
  • 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 Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN GOERTZ
Title or Position: OWNER
Credential: LPC
Phone: 520-230-5626