# MY THERAPIST INC

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

## Provider details

- **NPI number:** 1922260082
- **Authorized official:** PATRICIA L BRADLEY BATES MED LPC LISAC (PRESIDENT OF MY THERAPIST INC)
- **Authorized official phone:** (480) 205-0062

## Contact information

- **Practice address:** 2435 E SOUTHERN AVE, STE 2, TEMPE, AZ 85282
- **Practice address phone:** (480) 205-0062
- **Practice address fax:** (480) 775-2789
- **Mailing address:** 2435 E SOUTHERN AVE, STE 2, TEMPE, AZ 85282
- **Mailing address phone:** (480) 205-0062
- **Mailing address fax:** (480) 775-2789

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | LISAC0052 | AZ | — |
| 106H00000X | Marriage & Family Therapist | LPC0757 | AZ | Yes |

## Other

- **Enumeration date:** 06/30/2008
- **Last updated:** 06/30/2008