| Lifeline Professional Counseling Services, Inc | |
|
1423 S Higley Rd Ste 103 Mesa AZ 85206-3449 | |
| (480) 641-1165 | |
| (480) 641-9026 |
| Full Name | Lifeline Professional Counseling Services, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1423 S Higley Rd Ste 103, Mesa, Arizona |
| Authorized Official Name and Position | John Delorenzo (CFO) |
| Authorized Official Contact | 4806411165 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeline Professional Counseling Services, Inc 335 N Alma School Rd Ste E Chandler AZ 85224-4363 Ph: (480) 641-1165 | Lifeline Professional Counseling Services, Inc 1423 S Higley Rd Ste 103 Mesa AZ 85206-3449 Ph: (480) 641-1165 |
| NPI Number | 1194285643 |
|---|---|
| Provider Enumeration Date | 03/21/2019 |
| Last Update Date | 05/27/2020 |
| Certification Date | 05/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194285643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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