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General NPI Number Information
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NPI Number | 1457725707
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Entity Type | Organization
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Legal Business Name | CENTERED LIVING COUNSELING & COACHING SERVICES, LLC
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Dates
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Enumeration Date | 11/24/2015
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Last Update Date | 11/25/2015
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Provider Practice Location Address
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Address Line | 44400 W HONEYCUTT RD SUITE 102
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City | MARICOPA
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State | AZ
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Zip | 85138-2944
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Country | US
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Telephone | 602-759-0812
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Fax |
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Provider Business Mailing Address
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Address Line | 44400 W HONEYCUTT RD SUITE 102
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City | MARICOPA
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State | AZ
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Zip | 85138-2944
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Country | US
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Telephone | 602-759-0812
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. KELLI CENTER
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Credential | LPC
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Telephone | 602-759-0812
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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 | LPC-15353
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-15353
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License Number State | AZ
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