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General NPI Number Information
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NPI Number | 1205999430
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Entity Type | Organization
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Legal Business Name | ARCADIA COUNSELING CENTER
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 3610 N. 44TH ST. #120
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City | PHOENIX
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State | AZ
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Zip | 85018
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Country | US
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Telephone | 602-218-6901
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Fax | 602-218-6901
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Provider Business Mailing Address
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Address Line | 3610 N. 44TH ST #120
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City | PHOENIX
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State | AZ
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Zip | 85018
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Country | US
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Telephone | 602-218-6901
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Fax | 602-218-6901
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | GREGORY SCOTT GIBSON
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Credential | MA, LPC
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Telephone | 602-218-6901
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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 | 11071
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11676
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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