Provider Demographics
NPI:1528731767
Name:ARIZONA OCD AND ANXIETY CENTER, LLC
Entity type:Organization
Organization Name:ARIZONA OCD AND ANXIETY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROFESSIONAL COUNSELOR(LPC)
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MCBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:602-755-2384
Mailing Address - Street 1:29038 N CARNELIAN DR
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-6269
Mailing Address - Country:US
Mailing Address - Phone:602-755-2384
Mailing Address - Fax:
Practice Address - Street 1:29038 N CARNELIAN DR
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-6269
Practice Address - Country:US
Practice Address - Phone:602-755-2384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-25
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLPC-19481OtherARIZONA BOARD OF BEHAVIORAL HEALTH EXAMINERS