Organization · Type 2 NPI

Id Substrate, PLLC

Mental Health Counselor · Phoenix, AZ

NPI number 1043930662 Active

Practice location

4500 N 32nd St Ste 100A
Phoenix, AZ 85018-3360

Call (602) 200-8690 Map

Fax (602) 264-8107

Mailing address

PO Box 10044
Phoenix, AZ 85064-0044

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed
Forensic Psychologist 103TF0200XNone listed
Group Psychotherapy Psychologist 103TP2701XNone listed

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About NPI 1043930662

Id Substrate, PLLC's National Provider Identifier is 1043930662, issued on Sep 1, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Phoenix, AZ. The record was last updated on Sep 1, 2022.