Provider Demographics
NPI:1003315292
Name:PERCEPTION COUNSELING
Entity Type:Organization
Organization Name:PERCEPTION COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:LOWTHER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYCHOLOGY
Authorized Official - Phone:520-300-0176
Mailing Address - Street 1:4801 W PIMA FARMS RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-4606
Mailing Address - Country:US
Mailing Address - Phone:520-300-0176
Mailing Address - Fax:
Practice Address - Street 1:1213 E WAREHOUSE AVENUE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719
Practice Address - Country:US
Practice Address - Phone:520-623-7077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERCEPTION COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-02
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC15863103K00000X, 103K00000X
103TA0400X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ362433Medicaid
AZ376891Medicaid
AZ1063729515Medicaid