MEDICARE: ASCENSION COUNSELING SERVICES

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	LPC11968	AZ

General Provider Information

NPI Number	:	1609016732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASCENSION COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	7901 N PATRICK HENRY PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-1524
Country	:	US
Telephone Number	:	520-661-4302
Fax Number	:

Provider Business Practice Location Address
First Line	:	12450 N RANCHO VISTOSO BLVD STE 100
Second Line	:
City	:	ORO VALLEY
State	:	AZ
Zip	:	85755-9567
Country	:	US
Telephone Number	:	520-661-4302
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. PALLAVI S. GUPTA
Credential	:	LPC
Telephone Number	:	520-661-4302

Provider Enumeration Date	:	03/02/2009
Last Update Date	:	03/02/2009

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