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General NPI Number Information
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NPI Number | 1689862831
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Entity Type | Individual
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Provider Name | RICHARD BROOKS CANFIELD MC, CEAP, LPC
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Gender | Male
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 4635 S LAKESHORE DR SUITE 112
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City | TEMPE
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State | AZ
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Zip | 85282-7127
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Country | US
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Telephone | 480-345-4477
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Fax |
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Provider Business Mailing Address
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Address Line | 3116 N 41ST PL
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City | PHOENIX
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State | AZ
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Zip | 85018-6413
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Country | US
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Telephone | 602-956-4299
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | LPC-0074
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License Number State | AZ
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