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General NPI Number Information
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NPI Number | 1487178679
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Entity Type | Organization
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Legal Business Name | DESTINY'S DOOR COUNSELING SERVICES
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Dates
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Enumeration Date | 07/28/2017
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 1631 E GUADALUPE RD STE 200
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City | TEMPE
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State | AZ
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Zip | 85283-3916
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Country | US
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Telephone | 480-788-0877
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8061
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City | PHOENIX
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State | AZ
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Zip | 85066-8061
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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 | SHARLI BERRY
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Credential | LPC
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Telephone | 480-788-0877
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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 | LPC16312
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License Number State | AZ
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