Provider Demographics
NPI:1851823009
Name:ADULT & ADOLESCENT RECOVERY COUNSELING
Entity Type:Organization
Organization Name:ADULT & ADOLESCENT RECOVERY COUNSELING
Other - Org Name:AARC THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:480-452-4483
Mailing Address - Street 1:1234 S POWER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-3740
Mailing Address - Country:US
Mailing Address - Phone:602-633-5032
Mailing Address - Fax:
Practice Address - Street 1:2500 S POWER RD
Practice Address - Street 2:STE. 107
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-6686
Practice Address - Country:US
Practice Address - Phone:602-633-5032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-15310101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty