Provider Demographics
NPI:1881405272
Name:SPACE BETWEEN
Entity type:Organization
Organization Name:SPACE BETWEEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PLOTE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:602-245-5975
Mailing Address - Street 1:1708 N 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85007-1616
Mailing Address - Country:US
Mailing Address - Phone:602-245-5975
Mailing Address - Fax:
Practice Address - Street 1:2111 E BASELINE RD STE D3
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1520
Practice Address - Country:US
Practice Address - Phone:602-245-5975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health