Provider Demographics
NPI:1295908234
Name:CENTER FOR HEALING PLAY, INC
Entity type:Organization
Organization Name:CENTER FOR HEALING PLAY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLAY THERAPIST/COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MC, LPC
Authorized Official - Phone:480-894-2281
Mailing Address - Street 1:1305 E CARSON DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7215
Mailing Address - Country:US
Mailing Address - Phone:602-690-0430
Mailing Address - Fax:
Practice Address - Street 1:2435 E SOUTHERN AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7628
Practice Address - Country:US
Practice Address - Phone:480-894-2281
Practice Address - Fax:480-894-2282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10994101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty