Provider Demographics
NPI:1558303867
Name:THE DEVEREUX FOUNDATION
Entity Type:Organization
Organization Name:THE DEVEREUX FOUNDATION
Other - Org Name:DEVEREUX ARIZONA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LANE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN-BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:480-998-2920
Mailing Address - Street 1:11000 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6130
Mailing Address - Country:US
Mailing Address - Phone:480-998-2920
Mailing Address - Fax:480-443-5587
Practice Address - Street 1:2320 W PEORIA AVE
Practice Address - Street 2:SUITE B-145
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4753
Practice Address - Country:US
Practice Address - Phone:602-944-6222
Practice Address - Fax:602-944-3534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty