Provider Demographics
NPI:1093590143
Name:BUILDING BLOCKS COUNSELING,LLC
Entity Type:Organization
Organization Name:BUILDING BLOCKS COUNSELING,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VERN
Authorized Official - Middle Name:P
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-626-8112
Mailing Address - Street 1:PO BOX 10690
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85064-0690
Mailing Address - Country:US
Mailing Address - Phone:602-975-2194
Mailing Address - Fax:
Practice Address - Street 1:4040 E MCDOWELL RD STE 219
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-4438
Practice Address - Country:US
Practice Address - Phone:602-975-2194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUILDING BLOCKS COUNSELING,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health