Alevea Mental Health Llc | |
2034 E Southern Ave Tempe AZ 85282-7522 | |
(480) 923-6200 | |
(602) 419-3101 |
Full Name | Alevea Mental Health Llc |
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Speciality | Physician Assistant |
Location | 2034 E Southern Ave, Tempe, Arizona |
Authorized Official Name and Position | Christopher Michael Bradshaw (CEO, PROVIDER) |
Authorized Official Contact | 6027330584 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Alevea Mental Health Llc 2034 E Southern Ave Ste D Tempe AZ 85282-7511 Ph: (480) 247-7476 | Alevea Mental Health Llc 2034 E Southern Ave Tempe AZ 85282-7522 Ph: (480) 923-6200 |
NPI Number | 1619482478 |
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Provider Enumeration Date | 12/02/2017 |
Last Update Date | 01/04/2024 |
Certification Date | 01/04/2024 |
Medicare PECOS PAC ID | 6608135652 |
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Medicare Enrollment ID | O20180119000457 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619482478 | NPI | - | NPPES |
135637 | Medicaid | AZ |
Provider Name | Michael L Vines |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1881641272 PECOS PAC ID: 9830138544 Enrollment ID: I20050502000516 |
Provider Name | Lisa Nicole Chica |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922408327 PECOS PAC ID: 9830519008 Enrollment ID: I20201009001423 |
Provider Name | Sara Gibson |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1932694734 PECOS PAC ID: 1153768460 Enrollment ID: I20240322000579 |
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