Provider Demographics
NPI:1558765420
Name:SPRINGBOARD COUNSELING SERIVCES, LLC
Entity Type:Organization
Organization Name:SPRINGBOARD COUNSELING SERIVCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-200-8556
Mailing Address - Street 1:9449 N 90TH STREET
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258
Mailing Address - Country:US
Mailing Address - Phone:888-672-2120
Mailing Address - Fax:888-672-2120
Practice Address - Street 1:9449 N 90TH ST
Practice Address - Street 2:SUITE 207
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5099
Practice Address - Country:US
Practice Address - Phone:888-672-2120
Practice Address - Fax:888-672-2120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMED5851251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health