Provider Demographics
NPI:1215638192
Name:ENLIGHTEN COUNSELING AND WELLNESS, LLC
Entity type:Organization
Organization Name:ENLIGHTEN COUNSELING AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:VAN BUSKIRK
Authorized Official - Suffix:
Authorized Official - Credentials:MC, LPC, CIMHP
Authorized Official - Phone:602-429-9972
Mailing Address - Street 1:13388 W CHAPAROSA WAY
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-7880
Mailing Address - Country:US
Mailing Address - Phone:602-429-9972
Mailing Address - Fax:602-429-9974
Practice Address - Street 1:2550 W UNION HILLS DR STE 350
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-5187
Practice Address - Country:US
Practice Address - Phone:602-429-9972
Practice Address - Fax:602-429-9974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty