MEDICARE: ARCADIA COUNSELING CENTER

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	101YP2500X	Professional Counselor	LPC-15962	AZ

General Provider Information

NPI Number	:	1407216518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARCADIA COUNSELING CENTER

Provider Business Mailing Address
First Line	:	3610 N 44TH ST STE 120
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-6060
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3610 N 44TH ST STE 120
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-6060
Country	:	US
Telephone Number	:	602-218-6901
Fax Number	:

Authorized Official
Title or Position	:	LICENSED CLINICAL SOCIAL WORKER
Name	:	LAURA T GREENWOOD
Credential	:
Telephone Number	:	602-218-6901

Provider Enumeration Date	:	03/02/2016
Last Update Date	:	03/02/2016

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Directions to “ARCADIA COUNSELING CENTER ” Practice Location

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