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General NPI Number Information
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NPI Number | 1386638492
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Entity Type | Individual
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Provider Name | GEORGE J JOUMAS M.A.
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Gender | Male
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 4545 E SHEA BLVD SUITE 112
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City | PHOENIX
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State | AZ
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Zip | 85028-3074
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Country | US
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Telephone | 602-392-2012
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Fax | 602-494-1728
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Provider Business Mailing Address
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Address Line | 4545 E SHEA BLVD SUITE 112
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City | PHOENIX
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State | AZ
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Zip | 85028-3074
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Country | US
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Telephone | 602-392-2012
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Fax | 602-494-1728
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-0514
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301007556
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License Number State | MI
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