# PHOENIX WELLNESS CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194232512
- **Authorized official:** TONYA KINNAMAN MA, NCC, LPC (CLINICAL DIRECTOR)
- **Authorized official phone:** (480) 653-8434

## Contact information

- **Practice address:** 2060 W WHISPERING WIND DR STE 270, PHOENIX, AZ 85085
- **Practice address phone:** (480) 653-8434
- **Practice address fax:** (623) 258-4077
- **Mailing address:** 2060 W WHISPERING WIND DR STE 270, PHOENIX, AZ 85085-2869
- **Mailing address phone:** (480) 653-8434
- **Mailing address fax:** (623) 258-4077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | CSLG8879 | AZ | Yes |
| 101YM0800X | Mental Health Counselor | OTC8779 | AZ | — |

## Other

- **Enumeration date:** 01/08/2018
- **Last updated:** 08/09/2018