Organization
MENDING HEARTS FAMILY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON ANN CARL MA, M. ED., LPC (PRESIDENT/CEO)
(602) 633-2246
Entity
Organization
Contact information
Practice address
17431 N. 71ST DR., SUITE 103, GLENDALE, AZ 85308
(602) 633-2246
(602) 687-7069
Mailing address
17431 N. 71ST DR., SUITE 103, GLENDALE, AZ 85308
(602) 633-2246
(602) 687-7069
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC - 1003
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
649014
AHCCCS
AZ
01
—
LPC-1003
LICENSED PROFESSIONAL COUNSELOR
AZ
01
—
S1642
REGISTERED PLAY THERAPY SUPERVISOR
—
Enumeration date
03/23/2010
Last updated
05/21/2020
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