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General NPI Number Information
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NPI Number | 1306142567
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Entity Type | Organization
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Legal Business Name | COMFORTABLE COUCH COUNSELING, LLC
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Dates
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Enumeration Date | 02/07/2011
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Last Update Date | 03/09/2012
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Provider Practice Location Address
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Address Line | 3825 W ANTHEM WAY UNIT 3117
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City | ANTHEM
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State | AZ
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Zip | 85086-3166
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Country | US
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Telephone | 520-261-2331
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Fax |
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Provider Business Mailing Address
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Address Line | 3825 W ANTHEM WAY UNIT 3117
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City | ANTHEM
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State | AZ
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Zip | 85086-3166
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Country | US
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Telephone | 520-261-2331
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Fax |
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Authorized Official
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Title or Position | OWNER,CEO
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Name | MS. LAUREN VOGINI
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Credential | LCSW ACSW
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Telephone | 520-261-2331
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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 | 11770
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License Number State | AZ
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