Provider Demographics
NPI:1568798080
Name:NASTA, PHYLLIS FRANCINE (LPC)
Entity Type:Individual
Prefix:MS
First Name:PHYLLIS
Middle Name:FRANCINE
Last Name:NASTA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 E GREENLEE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1267
Mailing Address - Country:US
Mailing Address - Phone:520-327-7071
Mailing Address - Fax:520-327-7071
Practice Address - Street 1:3117 E GREENLEE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-1267
Practice Address - Country:US
Practice Address - Phone:520-327-7071
Practice Address - Fax:520-327-7071
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC 1338101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health