Provider Demographics
NPI:1053603399
Name:NORTH PHOENIX COUNSELING
Entity type:Organization
Organization Name:NORTH PHOENIX COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:623-738-1290
Mailing Address - Street 1:39506 N DAISY MOUNTAIN DR
Mailing Address - Street 2:STE 122-160
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1663
Mailing Address - Country:US
Mailing Address - Phone:623-738-1290
Mailing Address - Fax:623-242-1588
Practice Address - Street 1:34975 N NORTH VALLEY PKWY
Practice Address - Street 2:SUITE 152
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086-4028
Practice Address - Country:US
Practice Address - Phone:623-738-1290
Practice Address - Fax:623-242-1588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-13569101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty