Provider Demographics
NPI:1457222952
Name:DIVERCITY MENTAL HEALTH SERVICES, PLLC
Entity type:Organization
Organization Name:DIVERCITY MENTAL HEALTH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GIANNINA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUILES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:623-293-2307
Mailing Address - Street 1:3825 N DENNY WAY
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-3657
Mailing Address - Country:US
Mailing Address - Phone:623-293-2309
Mailing Address - Fax:
Practice Address - Street 1:3825 N DENNY WAY
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-3657
Practice Address - Country:US
Practice Address - Phone:623-293-2309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty