MRS. DEJA PRESTIGE LAC
NPI 1831022409
Counselor - Mental Health in Phoenix, AZ

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

Active since June 04, 2026

3330 N 2ND ST STE 601, PHOENIX, AZ 85012(602) 230-7373(602) 682-7455 Get Directions Write a Review

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Mrs. Deja Prestige Lac NPPES

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

MRS. DEJA PRESTIGE LAC (NPI 1831022409) is an individual mental health provider in Phoenix, Arizona, licensed in Arizona (LAC-22925) and active in the NPI registry since June 2026.

NPPES Registry Identity

NPI1831022409

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameMRS. DEJA PRESTIGECredential: LAC

Location Address3330 N 2ND ST STE 601Phoenix, AZ 85012-2395

Mailing Address3101 N Central Ave Ste 550Phoenix, AZ 85012-2635 · (602) 230-7373 · Fax (602) 682-7455

Phone(602) 230-7373

Fax(602) 682-7455

Sole ProprietorNo

Enumeration DateJune 4, 2026

NPPES CertifiedJune 4, 2026

✔ NPI 1831022409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in AZ · LAC-22925

3330 N 2ND ST STE 601, Phoenix, AZ 85012

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Other Providers at the Same Location NPPES 20

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

SYDNEY L WALLACE LAC

Counselor