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General NPI Number Information
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NPI Number | 1265940092
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Entity Type | Organization
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Legal Business Name | CFG, PLLC
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Dates
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Enumeration Date | 01/15/2018
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Last Update Date | 01/15/2018
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Provider Practice Location Address
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Address Line | 10446 N 74TH ST STE 140
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-1045
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Country | US
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Telephone | 480-699-9044
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Fax |
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Provider Business Mailing Address
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Address Line | 4616 N 33RD PL
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City | PHOENIX
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State | AZ
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Zip | 85018-3958
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Country | US
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Telephone | 480-699-9044
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. RUSSELL FERRARA
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Credential |
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Telephone | 561-926-4223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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