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General NPI Number Information
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NPI Number | 1417766858
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Entity Type | Organization
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Legal Business Name | NOVA PSYCHOTHERAPY SERVICES
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 690 E WARNER RD STE 153
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City | GILBERT
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State | AZ
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Zip | 85296-3059
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Country | US
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Telephone | 602-890-0218
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Fax |
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Provider Business Mailing Address
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Address Line | 680 E WINDSOR DR
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City | GILBERT
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State | AZ
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Zip | 85296-4124
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GINKA CONREY
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Credential | LCSW
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Telephone | 229-854-5162
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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 |
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License Number State |
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