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General NPI Number Information
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NPI Number | 1104787530
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Entity Type | Individual
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Provider Name | SHAINA BROCKWAY
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Gender | Female
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 1616 N LITCHFIELD RD STE 270
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City | GOODYEAR
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State | AZ
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Zip | 85395-1289
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Country | US
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Telephone | 623-288-9137
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Fax |
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Provider Business Mailing Address
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Address Line | 23576 W PECAN RD
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City | BUCKEYE
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State | AZ
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Zip | 85326-7233
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Country | US
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Telephone | 602-373-6760
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-21206
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License Number State | AZ
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