Provider Demographics
NPI:1013722040
Name:TRAIN, EMILY (BS)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:TRAIN
Suffix:
Gender:
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17505 N 79TH AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8724
Mailing Address - Country:US
Mailing Address - Phone:602-292-1862
Mailing Address - Fax:
Practice Address - Street 1:17505 N 79TH AVE STE 105
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8724
Practice Address - Country:US
Practice Address - Phone:602-292-1862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1043982747OtherNPI TYPE 2 ORGANIZATIONAL/FACILITY
AZCSLG13230OtherARIZONA DEPARTMENT OF HEALTH SERVICES
AZ125011Medicaid
AZ1740851542OtherJANUARY HARTZE OF HEALING HARTZE INDIVIDUAL NPI