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General NPI Number Information
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NPI Number | 1144690942
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Entity Type | Organization
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Legal Business Name | YUMA COUNSELING SERVICES
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Dates
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Enumeration Date | 10/06/2015
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Last Update Date | 04/14/2017
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Provider Practice Location Address
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Address Line | 2201 S. AVENUE A SUITE 102
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City | YUMA
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State | AZ
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Zip | 85364-8460
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Country | US
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Telephone | 928-276-9535
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Fax | 928-247-6602
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Provider Business Mailing Address
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Address Line | 2201 S. AVENUE A SUITE 102
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City | YUMA
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State | AZ
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Zip | 85364-8460
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Country | US
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Telephone | 928-276-9535
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Fax | 928-247-6602
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. TROY L. LOVE
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Credential | LCSW
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Telephone | 928-276-9535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | BH4690
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License Number State | AZ
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