Provider Demographics
NPI:1104554237
Name:EAST VALLEY FAMILY THERAPY
Entity type:Organization
Organization Name:EAST VALLEY FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARROP
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:602-759-0512
Mailing Address - Street 1:21321 E OCOTILLO RD STE 132
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-5995
Mailing Address - Country:US
Mailing Address - Phone:602-759-0512
Mailing Address - Fax:602-584-7290
Practice Address - Street 1:21321 E OCOTILLO RD STE 132
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-5995
Practice Address - Country:US
Practice Address - Phone:602-759-0512
Practice Address - Fax:602-584-7290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health