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General NPI Number Information
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NPI Number | 1093128548
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Entity Type | Organization
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Legal Business Name | BIG HEART BEHAVIORAL HEALTH SERVICES, PLLC
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 4400 SCOTTSDALE ROAD, SUITE 9-927
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City | SCOTTSDALE
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State | AZ
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Zip | 85251
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Country | US
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Telephone | 520-370-9032
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 N. SCOTTSDALE ROAD, SUITE 9-297
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City | SCOTTSDALE
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State | AZ
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Zip | 85251
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Country | US
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Telephone | 520-370-9032
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. TERESA L KOLODNY
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Credential | PH.D. LPC
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Telephone | 520-370-9032
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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-122231
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License Number State | AZ
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