Provider Demographics
NPI:1467818260
Name:DR. DANI'S THERAPY AND PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:DR. DANI'S THERAPY AND PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GODFREDSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:602-705-4259
Mailing Address - Street 1:6946 E PINCHOT AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6863
Mailing Address - Country:US
Mailing Address - Phone:602-705-4259
Mailing Address - Fax:
Practice Address - Street 1:3295 N DRINKWATER BLVD
Practice Address - Street 2:4
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6492
Practice Address - Country:US
Practice Address - Phone:602-705-4259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4660103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty