Individual
DESIREE DAWN STANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CADC III
Contact information
Practice address
15878 W STATLER ST, SURPRISE, AZ 85374-5726
(503) 510-0276
Mailing address
15878 W STATLER ST, SURPRISE, AZ 85374-5726
(503) 510-0276
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
20-05-25
OR
101YM0800X
Mental Health Counselor
C5305
OR
101YM0800X
Mental Health Counselor
Primary
LPC-23078
AZ
Other
Enumeration date
04/20/2016
Last updated
01/16/2025
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