SOUTHERN MAGNOLIA THERAPY LLC
NPI 1003615238
Counselor - Mental Health in Goodyear, AZ

Q: What is Southern Magnolia Therapy LLC's NPI number?

The NPI number for Southern Magnolia Therapy LLC is 1003615238. It was assigned to this organization in the NPPES registry on March 11, 2025.

Q: What is Southern Magnolia Therapy LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Active since March 11, 2025

25 N 173RD AVE APT 2, GOODYEAR, AZ 85338(864) 979-1325 Get Directions Write a Review

NPPES record last updated: May 5, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 5, 2026, Mar 11, 2025 (2 updates tracked since 2025).

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About Southern Magnolia Therapy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN MAGNOLIA THERAPY LLC (NPI 1003615238) is a healthcare organization registered as a mental health in Goodyear, Arizona and active in the NPI registry since March 2025. The organization lists Ingram Malcolm Kerry Dirton, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1003615238

Entity TypeOrganization

Primary Taxonomy101YM0800X

Legal Business NameSOUTHERN MAGNOLIA THERAPY LLC

Location Address25 N 173RD AVE APT 2Goodyear, AZ 85338-6712

Mailing Address25 N 173rd Ave Apt 2Goodyear, AZ 85338-6712 · (864) 979-1325

Phone(864) 979-1325

Organization SubpartNo

Authorized OfficialIngram Malcolm Kerry DirtonClinical Director · (864) 979-1325

Enumeration DateMarch 11, 2025

Last NPPES UpdateMay 5, 20262 updates tracked since enumeration

NPPES CertifiedMay 5, 2026

✔ NPI 1003615238 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

25 N 173RD AVE APT 2, Goodyear, AZ 85338

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CRISIS RECOVERY COUNSELING PLLC

Counselor (Mental Health)

25 N 173RD AVE APT 2
GOODYEAR, AZ 85338

Maricopa County (864) 979-1325

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Magnolia Therapy LLC's NPI number?

The NPI number for Southern Magnolia Therapy LLC is 1003615238. It was assigned to this organization in the NPPES registry on March 11, 2025.

Where is Southern Magnolia Therapy LLC located?

Southern Magnolia Therapy LLC is located at 25 N 173rd Ave Apt 2, Goodyear, AZ 85338. The listed phone number is (864) 979-1325.

What is Southern Magnolia Therapy LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Southern Magnolia Therapy LLC was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.