Provider Demographics
NPI:1881819910
Name:SAND CASTLE COUNSELING INC
Entity Type:Organization
Organization Name:SAND CASTLE COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:GAYE
Authorized Official - Last Name:HEATH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:928-772-4464
Mailing Address - Street 1:8430 E SPOUSE DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314
Mailing Address - Country:US
Mailing Address - Phone:928-772-4464
Mailing Address - Fax:928-772-7595
Practice Address - Street 1:8430 E SPOUSE DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314
Practice Address - Country:US
Practice Address - Phone:928-772-4464
Practice Address - Fax:928-772-7595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT10073106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty