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General NPI Number Information
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NPI Number | 1568912756
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Entity Type | Organization
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Legal Business Name | ARTISAN BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 10/11/2016
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 4450 S RURAL RD SUITE E-125
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City | TEMPE
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State | AZ
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Zip | 85282-7037
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Country | US
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Telephone | 480-659-8245
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Fax | 480-471-8186
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Provider Business Mailing Address
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Address Line | PO BOX 27228
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City | TEMPE
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State | AZ
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Zip | 85285-7228
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Country | US
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Telephone | 480-659-8245
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Fax | 480-471-8186
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Authorized Official
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Title or Position | COUNSELOR
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Name | TAMMY LEA MCFADDEN
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Credential | LPC, LISAC
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Telephone | 480-659-8245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LISAC-11856
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC-13296
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License Number State | AZ
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