Provider Demographics
NPI:1477308559
Name:ESTRELLA COUNSELING SERVICES
Entity type:Organization
Organization Name:ESTRELLA COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCGUIRK
Authorized Official - Suffix:
Authorized Official - Credentials:LISAC-11106
Authorized Official - Phone:480-797-1328
Mailing Address - Street 1:250 N LITCHFIELD RD STE 150
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-1379
Mailing Address - Country:US
Mailing Address - Phone:623-925-8420
Mailing Address - Fax:
Practice Address - Street 1:250 N LITCHFIELD RD STE 150
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-1379
Practice Address - Country:US
Practice Address - Phone:623-925-8420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty