Provider Demographics
NPI:1598550527
Name:CANFIELD COUNSELING
Entity type:Organization
Organization Name:CANFIELD COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-407-8962
Mailing Address - Street 1:3635 E INVERNESS AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-3848
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3635 E INVERNESS AVE STE 109
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-3848
Practice Address - Country:US
Practice Address - Phone:602-610-4325
Practice Address - Fax:480-581-5323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1811121536Medicaid