Provider Demographics
NPI:1306142567
Name:COMFORTABLE COUCH COUNSELING, LLC
Entity type:Organization
Organization Name:COMFORTABLE COUCH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER,CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:VOGINI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW ACSW
Authorized Official - Phone:520-261-2331
Mailing Address - Street 1:3825 W ANTHEM WAY UNIT 3117
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-3166
Mailing Address - Country:US
Mailing Address - Phone:520-261-2331
Mailing Address - Fax:
Practice Address - Street 1:3825 W ANTHEM WAY UNIT 3117
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-3166
Practice Address - Country:US
Practice Address - Phone:520-261-2331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ117701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ11770OtherAZ STATE LICENSURE