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General NPI Number Information
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NPI Number | 1215705579
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Entity Type | Organization
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Legal Business Name | UNSHACKLED MINDS COUNSELING PLLC
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Dates
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Enumeration Date | 12/18/2023
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Last Update Date | 12/18/2023
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Provider Practice Location Address
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Address Line | 13271 W SMOKI CT UNIT A
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City | GLENDALE
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State | AZ
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Zip | 85307-3267
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Country | US
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Telephone | 26-345-1795
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Fax |
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Provider Business Mailing Address
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Address Line | 13271 W SMOKI CT UNIT A
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City | GLENDALE
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State | AZ
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Zip | 85307-3267
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Country | US
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Telephone | 912-224-4427
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Fax |
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Authorized Official
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Title or Position | OWNER/ CLINICAL THERAPIST
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Name | MRS. ERICA ZONOBIA VARNER-ANDERSON
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Credential | LPC, LAMFT
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Telephone | 602-345-1795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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