Organization
LIFELINE PROFESSIONAL COUNSELING SERVICES, INC
Active
Other names
Lifeline PCS -Southeast
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROXANNE DALPOS PH.D (PRESIDENT)
(480) 203-8414
Entity
Organization
Contact information
Practice address
7565 E EAGLE CREST DR STE 101, MESA, AZ 85207-1041
(480) 641-1165
(480) 641-9026
Mailing address
335 N ALMA SCHOOL RD STE E, CHANDLER, AZ 85224-4363
(817) 965-5908
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BH8238
—
AZ
Enumeration date
11/10/2022
Last updated
11/16/2022
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