Provider Demographics
NPI:1245074855
Name:PERSPECTIVES COUNSELING PROFESSIONAL LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:PERSPECTIVES COUNSELING PROFESSIONAL LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOVAR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:520-975-3136
Mailing Address - Street 1:5656 E GRANT RD STE 110
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2921 N GRAND AVE STE 2
Practice Address - Street 2:
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621-3921
Practice Address - Country:US
Practice Address - Phone:520-975-3136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERSPECTIVES COUNSELING PROFESSIONAL LIMITED LIABILITY COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1508451451Medicaid
AZ1558122101Medicaid
AZ1356108088Medicaid
AZ1245074855Medicaid