Provider Demographics
NPI:1215737382
Name:BEGODY, ELAYNA NICOLE
Entity type:Individual
Prefix:
First Name:ELAYNA
Middle Name:NICOLE
Last Name:BEGODY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2936 N 34TH PL APT 23
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-7417
Mailing Address - Country:US
Mailing Address - Phone:760-859-5571
Mailing Address - Fax:
Practice Address - Street 1:1440 E MISSOURI AVE STE 270
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2462
Practice Address - Country:US
Practice Address - Phone:480-448-1076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health