| Organization Name: | DESERT EAGLE COUNSELING SERVICES, PLLC |
| NPI Number: | 1730504796 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHNNY JASON BUCK (OWNER) |
| Mailing Address: | 1835 W Chandler Blvd Ste 100 Chandler |
| State: | AZ US |
| Postal Code: | 852245286 |
| Phone Number: | 4802691733 |
| Fax Number: | |
| NPI Enumeration Date: | 02/27/2014 |
| NPI Last Update Date: | 09/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | LPC-13746 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |