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General NPI Number Information
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NPI Number | 1659905743
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Entity Type | Organization
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Legal Business Name | NEW LEGACY COUNSELING, AZ, PLLC
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Dates
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Enumeration Date | 02/27/2020
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Last Update Date | 02/27/2020
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Provider Practice Location Address
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Address Line | 1206 E WARNER RD STE 118
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City | GILBERT
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State | AZ
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Zip | 85296-3133
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Country | US
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Telephone | 480-712-6242
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Fax |
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Provider Business Mailing Address
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Address Line | 22511 S 202ND ST
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-6259
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Country | US
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Telephone | 480-737-6138
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHERRI DAWN HELTERBRAN
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Credential | LPC
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Telephone | 480-737-6138
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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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