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General NPI Number Information
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NPI Number | 1053603399
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Entity Type | Organization
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Legal Business Name | NORTH PHOENIX COUNSELING
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 05/04/2011
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Provider Practice Location Address
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Address Line | 34975 N NORTH VALLEY PKWY SUITE 152
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City | PHOENIX
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State | AZ
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Zip | 85086-4028
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Country | US
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Telephone | 623-738-1290
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Fax | 623-242-1588
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Provider Business Mailing Address
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Address Line | 39506 N DAISY MOUNTAIN DR STE 122-160
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City | PHOENIX
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State | AZ
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Zip | 85086-1663
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Country | US
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Telephone | 623-738-1290
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Fax | 623-242-1588
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Authorized Official
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Title or Position | OWNER
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Name | CESAR GAMEZ
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Credential | LPC
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Telephone | 623-738-1290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC-13569
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License Number State | AZ
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