Provider Demographics
NPI:1427370048
Name:DESERT HOPE PSYCHOTHERAPY AND CONSULTATION SERVICES, LLC
Entity Type:Organization
Organization Name:DESERT HOPE PSYCHOTHERAPY AND CONSULTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LEGENDRE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MPA
Authorized Official - Phone:520-326-2919
Mailing Address - Street 1:2767 N DESERT AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1957
Mailing Address - Country:US
Mailing Address - Phone:520-326-2919
Mailing Address - Fax:520-326-2919
Practice Address - Street 1:2767 N DESERT AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1957
Practice Address - Country:US
Practice Address - Phone:520-326-2919
Practice Address - Fax:520-326-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-0325106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty