Provider Demographics
NPI:1932277480
Name:HUMAN SERVICES CONSULTANTS
Entity type:Organization
Organization Name:HUMAN SERVICES CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMIAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KIRWAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:602-738-5487
Mailing Address - Street 1:P.O. BOX 16906
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85011-6906
Mailing Address - Country:US
Mailing Address - Phone:602-279-1427
Mailing Address - Fax:602-279-1431
Practice Address - Street 1:4449 N 12TH STREET
Practice Address - Street 2:SUITE B-1
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4596
Practice Address - Country:US
Practice Address - Phone:602-279-1427
Practice Address - Fax:602-279-1431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH 2842251S00000X
AZBH-3513251S00000X
AZOTC5939251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ707911Medicaid