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General NPI Number Information
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NPI Number | 1376601914
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Entity Type | Organization
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Legal Business Name | BRIGHTER HEIGHTS ARIZONA, LLC
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 2517 N GREAT WESTERN DR STE P
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-2597
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Country | US
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Telephone | 928-777-4131
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Fax | 928-227-4589
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Provider Business Mailing Address
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Address Line | 2517 N GREAT WESTERN DR STE P
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-2597
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Country | US
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Telephone | 928-777-4131
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Fax | 928-227-4589
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Authorized Official
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Title or Position | SENIOR CREDENTIALING SPECIALIST
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Name | MRS. BROOKE WILSON
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Credential |
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Telephone | 928-772-4131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | BH-2730
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | BH-3517
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License Number State | AZ
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