Provider Demographics
NPI:1962041889
Name:GEOMANCIE PROMISE LLC WITH HELLINGER SYSTEMIC CONSTELLATIONS
Entity type:Organization
Organization Name:GEOMANCIE PROMISE LLC WITH HELLINGER SYSTEMIC CONSTELLATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCIRVIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:541-731-4256
Mailing Address - Street 1:3741 S BRIGHTON LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-7976
Mailing Address - Country:US
Mailing Address - Phone:458-205-8943
Mailing Address - Fax:458-210-2788
Practice Address - Street 1:7096 E SAN CRISTOBAL WAY
Practice Address - Street 2:
Practice Address - City:GOLD CANYON
Practice Address - State:AZ
Practice Address - Zip Code:85118-1838
Practice Address - Country:US
Practice Address - Phone:458-205-8943
Practice Address - Fax:458-210-2788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-23
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty