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Id Substrate, Pllc
Group Psychotherapy Psychologist in Phoenix, Arizona
NPI 1588387005

Id Substrate, Pllc is a Group Psychotherapy Psychologist based in Phoenix, AZ and is specialized in Group Psychotherapy. Id Substrate, Pllc practices in Phoenix, AZ. The NPI Number for Id Substrate, Pllc is 1588387005 and holds a License No. (Arizona).

The current practice location address for Id Substrate, Pllc is 4500 N. 32Nd Street, Phoenix, AZ and can be reached out via phone at 602-200-8690 and via fax at 602-264-8107.

Location: 4500 N. 32Nd Street, Phoenix, AZ, 85064-0044
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1588387005
Provider Name
Id Substrate, Pllc
Credential
Provider Entity Type
Organization
Address
4500 N. 32Nd Street, Phoenix, AZ, 85064-0044
Phone Number
602-200-8690
Fax Number
602-264-8107
Provider Enumeration Date
09/20/2022
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
4500 N. 32Nd Street
City
Phoenix
State
Arizona
Zip
85018-3033
Phone Number
602-200-8690
Fax Number
602-264-8107
person
Provider Business Mailing Address Details
Address
4500 N. 32Nd Street
City
Phoenix
State
Arizona
Zip
85018-3033
Phone Number
602-200-8690
Fax Number
602-264-8107
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Forensic
Taxonomy
103TF0200X
License No.
()
Definition
A psychologist whose specialty is characterized by activities primarily intended to provide professional psychological expertise within the judicial and legal systems.
person
Provider's Taxonomy Details 4
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Group Psychotherapy
Taxonomy
103TP2701X
License No.
()
Definition
A psychologist who specializes in group psychology and group psychotherapy that is an evidenced-based specialty that prepares group leaders to identify and capitalize on developmental and healing possibilities embedded in the interpersonal/intrapersonal functioning of individual group members as well as collectively for the group. Emphasis is placed on the use of group dynamics to assist and treat individual group members. The specialty is applicable to all age groups, children, adolescents, adults and older adults, for a wide variety of conditions and concerns, and in numerous and diverse settings.
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