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General NPI Number Information
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NPI Number | 1538271630
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Entity Type | Organization
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Legal Business Name | COUNSELING COVENANT, LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/08/2016
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Provider Practice Location Address
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Address Line | 15152 N FRANK LLOYD WRIGHT BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-2869
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Country | US
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Telephone | 602-810-0933
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Fax | 623-266-7030
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Provider Business Mailing Address
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Address Line | 2550 E ROSE GARDEN LN #71155
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City | PHOENIX
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State | AZ
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Zip | 85050-7707
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Country | US
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Telephone | 602-810-0933
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Fax | 623-266-7030
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. BEVERLY GAY RITLAND
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Credential | LCSW
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Telephone | 602-810-0933
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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 | 11087
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License Number State | AZ
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