Organization
SURESTEP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
XANTHIA ANGEL WALKER (CEO)
(480) 381-4869
Entity
Organization
Contact information
Practice address
1220 S ALMA SCHOOL RD, SUITE 210, MESA, AZ 85210-2068
(480) 689-4316
Mailing address
1220 S ALMA SCHOOL RD, SUITE 210, MESA, AZ 85210-2068
(480) 689-4316
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
10/07/2011
Last updated
10/07/2011
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