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General NPI Number Information
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NPI Number | 1922959600
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Entity Type | Organization
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Legal Business Name | SEABREEZE HAVEN COUNSELING LLC
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Dates
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Enumeration Date | 02/07/2026
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Last Update Date | 02/07/2026
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Provider Practice Location Address
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Address Line | 9507 W MAGNUM DR # 4467
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City | ARIZONA CITY
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State | AZ
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Zip | 85123-8967
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Country | US
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Telephone | 480-532-2716
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4467
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City | ARIZONA CITY
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State | AZ
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Zip | 85123-2637
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Country | US
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Telephone | 480-532-2716
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH PRACTITIONER
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Name | SANDY JANICKI
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Credential | LAC
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Telephone | 480-532-2716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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