Basic Information
| Provider Information | |||||||||
| NPI: | 1760838346 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GIURGIU | ||||||||
| FirstName: | BIANCA | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1012 S STAPLEY DR | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852044270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4807686022 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1012 S STAPLEY DR | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852044270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4807686022 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2016 | ||||||||
| LastUpdateDate: | 06/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | A4334 | OR | N | Behavioral Health & Social Service Providers | Counselor | 1041C0700X | 18182 | AZ | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.