Provider Demographics
NPI:1326273608
Name:REHABILITATION SPECIALISTS GROUP, INC.
Entity Type:Organization
Organization Name:REHABILITATION SPECIALISTS GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ATHA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CVE, LPC
Authorized Official - Phone:623-889-7420
Mailing Address - Street 1:2501 W DUNLAP AVE STE 265
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-2742
Mailing Address - Country:US
Mailing Address - Phone:623-889-7420
Mailing Address - Fax:623-487-5458
Practice Address - Street 1:7992 W THUNDERBIRD RD STE 111C
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4905
Practice Address - Country:US
Practice Address - Phone:623-889-7420
Practice Address - Fax:623-487-5458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-0543101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty