Organization
ASPIRING ANEW GENERATION CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA STANFORD PHD (CEO)
(602) 581-8860
Entity
Organization
Contact information
Practice address
2701 E THOMAS RD STE K, PHOENIX, AZ 85016-8218
(480) 382-2444
(602) 314-5813
Mailing address
4478 S MARION PL, CHANDLER, AZ 85249-4791
(602) 570-5633
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
106S00000X
Behavior Technician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
01/26/2023
Last updated
03/21/2024
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