Provider Demographics
NPI:1477924256
Name:COMPREHENSIVE FITNESS & CONSULTATION, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE FITNESS & CONSULTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:K
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:623-215-9958
Mailing Address - Street 1:34406 N 27TH DR
Mailing Address - Street 2:BLDG 6, SUITE 118
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-6082
Mailing Address - Country:US
Mailing Address - Phone:623-215-9958
Mailing Address - Fax:623-215-9959
Practice Address - Street 1:34406 N 27TH DR
Practice Address - Street 2:BLDG 6, SUITE 118
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-6082
Practice Address - Country:US
Practice Address - Phone:623-215-9958
Practice Address - Fax:623-215-9959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4670103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty