MEDICARE: TELESPERA COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1295517852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TELESPERA COUNSELING

Provider Business Mailing Address
First Line	:	4539 N 22ND ST STE R
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4639
Country	:	US
Telephone Number	:	520-841-5482
Fax Number	:	520-645-2685

Provider Business Practice Location Address
First Line	:	4539 N 22ND ST STE R
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4639
Country	:	US
Telephone Number	:	520-391-6188
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	TAMMY L ROME
Credential	:	LPC
Telephone Number	:	520-391-6188

Provider Enumeration Date	:	10/18/2023
Last Update Date	:	01/14/2026

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Directions to “TELESPERA COUNSELING ” Practice Location

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