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General NPI Number Information
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NPI Number | 1568099588
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Entity Type | Organization
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Legal Business Name | TRI CHANGE COUNSELING
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 05/02/2022
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Provider Practice Location Address
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Address Line | 64 E BROADWAY RD STE 200
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City | TEMPE
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State | AZ
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Zip | 85282-1377
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Country | US
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Telephone | 480-280-0918
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Fax | 480-372-4005
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Provider Business Mailing Address
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Address Line | 9605 S 48TH ST APT 1013
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City | PHOENIX
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State | AZ
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Zip | 85044-5659
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Country | US
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Telephone | 970-682-8422
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SAMANTHA A HIGGINS
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Credential | LPC
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Telephone | 970-682-8422
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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