Provider Demographics
NPI:1790190031
Name:TOUCHON, GIGI MARIE (LISAC, LMSW)
Entity Type:Individual
Prefix:MS
First Name:GIGI
Middle Name:MARIE
Last Name:TOUCHON
Suffix:
Gender:F
Credentials:LISAC, LMSW
Other - Prefix:MS
Other - First Name:GIGI
Other - Middle Name:MARIE
Other - Last Name:TOUCHON-GREBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISAC, LMSW
Mailing Address - Street 1:3002 W CORRINE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-1315
Mailing Address - Country:US
Mailing Address - Phone:602-485-4649
Mailing Address - Fax:
Practice Address - Street 1:8 E COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4382
Practice Address - Country:US
Practice Address - Phone:877-634-7333
Practice Address - Fax:866-984-3891
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-10412101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLMSW-13124OtherARIZONA BOARD OF BEHAVIORAL HEALTH
AZLISAC-10412OtherARIZONA BOARD OF BEHAVIORAL HEALTH