| Circle Of Life Counseling, Pllc | |
|
4121 E Valley Auto Dr Suite 122 Mesa AZ 85206-4631 | |
| (602) 410-3406 | |
| (480) 636-8440 |
| Full Name | Circle Of Life Counseling, Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4121 E Valley Auto Dr, Mesa, Arizona |
| Authorized Official Name and Position | Thomas White (STATUTORY AGENT) |
| Authorized Official Contact | 6024203406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Circle Of Life Counseling, Pllc 1474 N Cooper Rd Suite 105-443 Gilbert AZ 85233-1237 Ph: (602) 410-3406 | Circle Of Life Counseling, Pllc 4121 E Valley Auto Dr Suite 122 Mesa AZ 85206-4631 Ph: (602) 410-3406 |
| NPI Number | 1467639302 |
|---|---|
| Provider Enumeration Date | 01/23/2008 |
| Last Update Date | 01/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467639302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LPC12028 (Arizona) | Primary |
| 1041C0700X | Social Worker - Clinical | LCSW10380 (Arizona) | Secondary |
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