# AZ PURE WELLNESS, LICENSED CLINICAL SOCIAL WORKER, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AZ Pure Wellness LLC, AZ Pure Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952032328
- **Authorized official:** VIVIAN FAJARDO LCSW (CLINICIAN MANAGER)
- **Authorized official phone:** (602) 825-3925

## Contact information

- **Practice address:** 7865 W BELL RD \# 1056, PEORIA, AZ 85382-3803
- **Practice address phone:** (602) 825-3925
- **Mailing address:** 7865 W BELL RD \# 1056, PEORIA, AZ 85382-3803
- **Mailing address phone:** (602) 825-3925

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 06/17/2022
- **Last updated:** 03/17/2025