1932301645 NPI number — MS. ROXANNE DALPOS PHD, LPC, NCC

Table of content: MS. ROXANNE DALPOS PHD, LPC, NCC (NPI 1932301645)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932301645 NPI number — MS. ROXANNE DALPOS PHD, LPC, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DALPOS
Provider First Name:
ROXANNE
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PHD, LPC, NCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932301645
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/11/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
402 E HELENA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85022-1829
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-430-8939
Provider Business Mailing Address Fax Number:
602-926-2372

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5040 E SHEA BLVD
Provider Second Line Business Practice Location Address:
#164
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85254-4600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-203-8414
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  LPC13318 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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