Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southern Magnolia Therapy LLC

Organization Mental Health Counselor · NPI 1003615238

Southern Magnolia Therapy LLC is a Mental Health Counselor in Goodyear, Arizona. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

25 N 173rd Ave Apt 2
Goodyear, AZ 85338-6712
Phone: (864) 979-1325
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1003615238
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ingram Dirton — Clinical Director · (864) 979-1325
NPI enumeratedMarch 11, 2025
Last updated in NPPESMay 5, 2026
Certification dateMay 5, 2026
Mailing address25 N 173rd Ave Apt 2, Goodyear, AZ 85338-6712

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