Provider Demographics
NPI:1215616735
Name:BUILDING BLOCKS COUNSELING,LLC
Entity type:Organization
Organization Name:BUILDING BLOCKS COUNSELING,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:VERN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-524-0583
Mailing Address - Street 1:PO BOX 10690
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85064-0690
Mailing Address - Country:US
Mailing Address - Phone:602-975-2194
Mailing Address - Fax:
Practice Address - Street 1:4040 E MCDOWELL RD STE 215&217
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-4414
Practice Address - Country:US
Practice Address - Phone:602-975-2194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUILDING BLOCKS COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health