| Clearfire Llc | |
|
1904 W Parkside Ln Phoenix AZ 85027-1228 | |
| (480) 757-5885 | |
| Not Available |
| Full Name | Clearfire Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1904 W Parkside Ln, Phoenix, Arizona |
| Authorized Official Name and Position | Micaela Wamboldt (LPC) |
| Authorized Official Contact | 4807575885 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clearfire Llc 13353 W Lariat Ln Peoria AZ 85383-5973 Ph: (480) 757-5885 | Clearfire Llc 1904 W Parkside Ln Phoenix AZ 85027-1228 Ph: (480) 757-5885 |
| NPI Number | 1861226342 |
|---|---|
| Provider Enumeration Date | 08/28/2024 |
| Last Update Date | 10/07/2024 |
| Certification Date | 10/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861226342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 171400000X | Health & Wellness Coach | (* (Not Available)) | Secondary |
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