Provider Demographics
NPI:1255969366
Name:SAGUARO SPRINGS HEALING CENTER, PLLC
Entity type:Organization
Organization Name:SAGUARO SPRINGS HEALING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS-WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LISAC, CCTP
Authorized Official - Phone:480-964-3914
Mailing Address - Street 1:4447 E BROADWAY RD STE 106
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-2018
Mailing Address - Country:US
Mailing Address - Phone:480-964-3914
Mailing Address - Fax:480-300-4128
Practice Address - Street 1:4447 E BROADWAY RD STE 106
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-2018
Practice Address - Country:US
Practice Address - Phone:480-964-3914
Practice Address - Fax:480-300-4128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty