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General NPI Number Information
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NPI Number | 1356847008
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Entity Type | Organization
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Legal Business Name | RESTORED LIFE COUNSELING
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 17230 N 59TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85308-3804
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Country | US
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Telephone | 360-558-7663
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Fax | 202-788-6490
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Provider Business Mailing Address
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Address Line | 17230 N 59TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85308-3804
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Country | US
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Telephone | 360-558-7663
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Fax | 202-788-6490
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Authorized Official
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Title or Position | DIRECTOR
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Name | DANIEL THOMAS STEPHENS
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Credential | MAC
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Telephone | 623-267-5849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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