Individual
TODD BASTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3033 N CENTRAL AVE STE 700, PHOENIX, AZ 85012-2806
(602) 230-7373
(602) 257-8029
Mailing address
8275 E BELL RD APT 1139, SCOTTSDALE, AZ 85260-1031
(480) 319-3533
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-16952
AZ
251S00000X
Community/Behavioral Health Agency
16952
AZ
Other
Enumeration date
11/16/2017
Last updated
02/08/2021
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