Desert Village Therapy Center, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

DESERT VILLAGE THERAPY CENTER, LLC

Practice address

2450 E Speedway Blvd Ste 3
Tucson, AZ 85719-4748

Phone

(520) 222-6693

NPI assigned

Jun 22, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisa Anne Gollenberg, LPCNPI 1609551738

Title

Member, Manager

Phone

(520) 222-6693

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Anne Gollenberg, LPC

  • Professional Counselor
  • Tucson, AZ
  • NPI 1609551738

  Professional

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1033895263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 E SPEEDWAY BLVD STE 3",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 E SPEEDWAY BLVD STE 3",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194748",
            "telephone_number": "520-222-6693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT VILLAGE THERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "GOLLENBERG",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "MEMBER, MANAGER",
        "authorized_official_telephone_number": "520-222-6693",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desert Sunrise Anesthesia PLLC
• Desert Survivors Inc.
• Desert Therapy Group PLLC
• Desert Urologic Specialists
• Desert Valley Physical Therapy, PLLC
• Desert Vista Hearing LLC
• Desert Willow Pediatrics, PLLC.
• Desert Zen Counseling, LLC
• Designer Dental Group PLLC
• Gregory Lewis Desilva, MD

• All providers in Tucson, AZ
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.