| NPI | 1316323686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR O OKORIE Chief Clinical Officer 602-441-2388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-13418) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LISAC-15037) |
| 101YM0800X Counselor Mental Health (Licence: AZ LCSW-10962) | |
| 103T00000X Psychologist (Licence: AZ 1076) | |
| 104100000X Social Worker (Licence: AZ LCSW-10962) | |
| 1041C0700X Social Worker Clinical (Licence: AZ LCSW-10962) | |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-08-10 |