Individual
MRS. MAMTA GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MC
Contact information
Practice address
1730 S JENTILLY LN, TEMPE, AZ 85281-5715
(480) 784-4644
(480) 460-8011
Mailing address
16847 S 1ST AVE, PHOENIX, AZ 85045-0718
(480) 784-4644
(480) 460-8011
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC1623
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
LPC1623
AZ
101YM0800X
Mental Health Counselor
LPC1623
AZ
Other
Enumeration date
08/30/2006
Last updated
09/11/2025
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