Organization
CIRCLE OF LIFE COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS WHITE L.P.C. (STATUTORY AGENT)
(602) 420-3406
Entity
Organization
Contact information
Practice address
4121 E VALLEY AUTO DR, SUITE 122, MESA, AZ 85206-4631
(602) 410-3406
(480) 636-8440
Mailing address
1474 N COOPER RD, SUITE 105-443, GILBERT, AZ 85233-1237
(602) 410-3406
(480) 636-8440
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC12028
AZ
1041C0700X
Clinical Social Worker
LCSW10380
AZ
Other
Enumeration date
01/23/2008
Last updated
01/23/2008
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