# CIRCLE OF LIFE COUNSELING, PLLC

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

## Provider details

- **NPI number:** 1467639302
- **Authorized official:** THOMAS WHITE L.P.C. (STATUTORY AGENT)
- **Authorized official phone:** (602) 420-3406

## Contact information

- **Practice address:** 4121 E VALLEY AUTO DR, SUITE 122, MESA, AZ 85206-4631
- **Practice address phone:** (602) 410-3406
- **Practice address fax:** (480) 636-8440
- **Mailing address:** 1474 N COOPER RD, SUITE 105-443, GILBERT, AZ 85233-1237
- **Mailing address phone:** (602) 410-3406
- **Mailing address fax:** (480) 636-8440

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | LPC12028 | AZ | Yes |
| 1041C0700X | Clinical Social Worker | LCSW10380 | AZ | — |

## Other

- **Enumeration date:** 01/23/2008
- **Last updated:** 01/23/2008