| Organization Name: | QUEEN CREEK COUNSELING LLC |
| NPI Number: | 1033441514 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAMELA CAROL DEAN (OWNER) |
| Mailing Address: | 21321 E Ocotillo Rd B-105 Queen Creek |
| State: | AZ US |
| Postal Code: | 851425996 |
| Phone Number: | 4802582915 |
| Fax Number: | 4808880231 |
| NPI Enumeration Date: | 02/08/2010 |
| NPI Last Update Date: | 02/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCSW-2854 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |