Basic Information
Provider Information
NPI: 1275184533
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PASCHALL
FirstName: CHRISTINA
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ZEMAN
OtherFirstName: CHRISTINA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 3003 N CENTRAL AVE STE 400
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850122929
CountryCode: US
TelephoneNumber: 6026856000
FaxNumber: 6026856002
Practice Location
Address1: 4909 E MCDOWELL RD
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850084227
CountryCode: US
TelephoneNumber: 6026856000
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/26/2019
LastUpdateDate: 09/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500XLPC-18236AZY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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