Provider Demographics
NPI:1538606140
Name:OPEN HEARTS OPEN MINDS COUNSELING SERVICES, LLC.
Entity type:Organization
Organization Name:OPEN HEARTS OPEN MINDS COUNSELING SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRISS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:602-677-3557
Mailing Address - Street 1:4545 E SHEA BLVD
Mailing Address - Street 2:SUITE 235
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028
Mailing Address - Country:US
Mailing Address - Phone:602-677-3557
Mailing Address - Fax:480-609-3778
Practice Address - Street 1:4545 E SHEA BLVD
Practice Address - Street 2:SUITE 235
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028
Practice Address - Country:US
Practice Address - Phone:602-677-3557
Practice Address - Fax:480-609-3778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-21
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC10792251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health