MEDICARE: APPROACH COUNSELING CENTER LLC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1780481945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APPROACH COUNSELING CENTER LLC

Provider Business Mailing Address
First Line	:	2201 N RAINBOW VISTA DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2912
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8478 E SPEEDWAY BLVD STE 300
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-1729
Country	:	US
Telephone Number	:	520-341-2359
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CLAYTON BLACK
Credential	:	LPC
Telephone Number	:	740-243-5542

Provider Enumeration Date	:	02/26/2025
Last Update Date	:	02/26/2025

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