Provider Demographics
NPI:1063999860
Name:TRAUMA RECOVERY SERVICES OF ARIZONA, PLLC
Entity type:Organization
Organization Name:TRAUMA RECOVERY SERVICES OF ARIZONA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JORDANNA
Authorized Official - Middle Name:LAVINA
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MC LPC
Authorized Official - Phone:602-626-0540
Mailing Address - Street 1:2990 N LITCHFIELD RD STE 7
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-7800
Mailing Address - Country:US
Mailing Address - Phone:623-300-1237
Mailing Address - Fax:623-335-0404
Practice Address - Street 1:2990 N LITCHFIELD RD STE 7
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-7800
Practice Address - Country:US
Practice Address - Phone:623-300-1237
Practice Address - Fax:623-335-0404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty