Provider Demographics
NPI:1942075767
Name:HENNES, ASHER (LAC)
Entity Type:Individual
Prefix:
First Name:ASHER
Middle Name:
Last Name:HENNES
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14300 N NORTHSIGHT BLVD STE 214
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3677
Mailing Address - Country:US
Mailing Address - Phone:602-550-0175
Mailing Address - Fax:
Practice Address - Street 1:14300 N NORTHSIGHT BLVD STE 214
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-3677
Practice Address - Country:US
Practice Address - Phone:602-550-0175
Practice Address - Fax:602-550-0175
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-08066T101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health