Provider Demographics
NPI:1841310117
Name:VERITAS COUNSELING CENTER, LLC
Entity type:Organization
Organization Name:VERITAS COUNSELING CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER - SINGLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:K
Authorized Official - Last Name:SPELLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, LISAC,
Authorized Official - Phone:602-863-3939
Mailing Address - Street 1:10640 N 28TH DR STE B202
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4506
Mailing Address - Country:US
Mailing Address - Phone:602-863-3939
Mailing Address - Fax:
Practice Address - Street 1:10640 N 28TH DR STE B202
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4506
Practice Address - Country:US
Practice Address - Phone:602-863-3939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-0101101YA0400X
AZLCSW-10181041C0700X
AZLMFT-0308106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0602491OtherBLUE CROSS BLUE SHIELD