| Codac Administration | |
|
1650 E Fort Lowell Rd Tucson AZ 85719-2378 | |
| (520) 327-4505 | |
| (520) 202-1889 |
| Full Name | Codac Administration |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1650 E Fort Lowell Rd, Tucson, Arizona |
| Authorized Official Name and Position | Dennis Regnier (CEO) |
| Authorized Official Contact | 5203274505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Codac Administration 1650 E Fort Lowell Rd Suite 202 Tucson AZ 85719-2378 Ph: (520) 327-4505 | Codac Administration 1650 E Fort Lowell Rd Tucson AZ 85719-2378 Ph: (520) 327-4505 |
| NPI Number | 1033156567 |
|---|---|
| Provider Enumeration Date | 06/01/2006 |
| Last Update Date | 03/15/2017 |
| Medicare PECOS PAC ID | 6103813811 |
|---|---|
| Medicare Enrollment ID | O20040426001693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033156567 | NPI | - | NPPES |
| 214427 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Larry G Onate |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316045750 PECOS PAC ID: 9931196854 Enrollment ID: I20040430000436 |
| Provider Name | Beth E Newhouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508881046 PECOS PAC ID: 5799753075 Enrollment ID: I20040923001013 |
| Provider Name | Audrey I Russell Kibble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164589974 PECOS PAC ID: 4082673371 Enrollment ID: I20041004000174 |
| Provider Name | John D Lewis |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1255386413 PECOS PAC ID: 2769440643 Enrollment ID: I20041222000869 |
| Provider Name | Steven J Bupp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780659029 PECOS PAC ID: 1658313531 Enrollment ID: I20050601000942 |
| Provider Name | Shawnee K Inez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013195528 PECOS PAC ID: 6204913742 Enrollment ID: I20080408000264 |
| Provider Name | James D Mcdaniel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982794160 PECOS PAC ID: 7012075799 Enrollment ID: I20081024000096 |
| Provider Name | Margaret A Webb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326004961 PECOS PAC ID: 5496815995 Enrollment ID: I20081113000331 |
| Provider Name | Kathryn L Clarke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265665467 PECOS PAC ID: 4587700414 Enrollment ID: I20091007000484 |
| Provider Name | Arlyn R Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962403113 PECOS PAC ID: 4688677024 Enrollment ID: I20100125000557 |
| Provider Name | Yanina Shames |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477863744 PECOS PAC ID: 6204017643 Enrollment ID: I20110218000178 |
| Provider Name | Susan Jane Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275771834 PECOS PAC ID: 8921165218 Enrollment ID: I20111017000365 |
| Provider Name | Lori N Popeski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518073790 PECOS PAC ID: 8527154046 Enrollment ID: I20120131000143 |
| Provider Name | Shannon L Padilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871840520 PECOS PAC ID: 9739339441 Enrollment ID: I20121015000384 |
| Provider Name | Sabreen H Boone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881827814 PECOS PAC ID: 2466602859 Enrollment ID: I20121019000492 |
| Provider Name | Jaime L Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801225073 PECOS PAC ID: 3577792910 Enrollment ID: I20140206000941 |
| Provider Name | Eddie P Ornelas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679518211 PECOS PAC ID: 7911120217 Enrollment ID: I20140513001846 |
| Provider Name | Robin Julianne Poedel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942637921 PECOS PAC ID: 3779706130 Enrollment ID: I20140603002272 |
| Provider Name | Justin J Egoville |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336410851 PECOS PAC ID: 9739309360 Enrollment ID: I20141002002596 |
| Provider Name | Jonathan Kandell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548297245 PECOS PAC ID: 8325340995 Enrollment ID: I20160113002672 |
| Provider Name | Sandra Np Walker-lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912338633 PECOS PAC ID: 0446483879 Enrollment ID: I20160616001167 |
| Provider Name | Susan R Dolence |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689907560 PECOS PAC ID: 2163713132 Enrollment ID: I20160622000870 |
| Provider Name | Catherine S Laughlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144328725 PECOS PAC ID: 8426341959 Enrollment ID: I20160721001240 |
| Provider Name | Lori S Solis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396839429 PECOS PAC ID: 2668421504 Enrollment ID: I20161123000105 |
| Provider Name | Babatunde O Sokan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346225703 PECOS PAC ID: 8628976024 Enrollment ID: I20170119002520 |
| Provider Name | Sarah M Sherman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154614485 PECOS PAC ID: 1153691365 Enrollment ID: I20170720002860 |
| Provider Name | Daniela A Losey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447609474 PECOS PAC ID: 8729353230 Enrollment ID: I20171010001840 |
| Provider Name | Oswald B Hakorinama |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104353929 PECOS PAC ID: 3577838960 Enrollment ID: I20171011001923 |
| Provider Name | Monica L Leverette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952834921 PECOS PAC ID: 3870867781 Enrollment ID: I20180529001536 |
| Provider Name | Murfy Morantus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174030936 PECOS PAC ID: 6709141013 Enrollment ID: I20180606003320 |
| Provider Name | Eris Norvilus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437663614 PECOS PAC ID: 1254696594 Enrollment ID: I20180607001228 |
| Provider Name | Nelda F Akinbile |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023112745 PECOS PAC ID: 8426086265 Enrollment ID: I20180629000508 |
| Provider Name | Christopher Parmanand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629578885 PECOS PAC ID: 4486902913 Enrollment ID: I20180731002641 |
| Provider Name | Adam Case |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669967220 PECOS PAC ID: 5698029254 Enrollment ID: I20181116002284 |
| Provider Name | Melody J Glenn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770826976 PECOS PAC ID: 6103118633 Enrollment ID: I20190925001076 |
| Provider Name | Eugene F Grzywacz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922647064 PECOS PAC ID: 1759717184 Enrollment ID: I20200204000616 |
| Provider Name | Maria E Nickel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760021042 PECOS PAC ID: 1254767700 Enrollment ID: I20200220001167 |
| Provider Name | Melanie Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518503945 PECOS PAC ID: 8820426893 Enrollment ID: I20200720003501 |
| Provider Name | Jaymien A Condoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285221648 PECOS PAC ID: 4183039258 Enrollment ID: I20210223001864 |
| Provider Name | Debra L Pugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801265053 PECOS PAC ID: 6406163591 Enrollment ID: I20210610003523 |
| Provider Name | Arturo D Ventura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891220257 PECOS PAC ID: 8628347846 Enrollment ID: I20210712002041 |
| Provider Name | Sakinah A Nemati |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467528836 PECOS PAC ID: 7315919990 Enrollment ID: I20210921003623 |
| Provider Name | Christiana L Billedalley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619631959 PECOS PAC ID: 7214069970 Enrollment ID: I20220407000758 |
| Provider Name | Mark Austin Grant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477016921 PECOS PAC ID: 1759617137 Enrollment ID: I20221010002936 |
| Provider Name | Justin W Gause |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1336703180 PECOS PAC ID: 9931577103 Enrollment ID: I20221118000937 |
| Provider Name | Sabina Pascaru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487351011 PECOS PAC ID: 4082079744 Enrollment ID: I20230502001567 |
| Provider Name | Lee A Pinkerton |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1710479670 PECOS PAC ID: 0941654248 Enrollment ID: I20230920001761 |
| Provider Name | Jami Van Brocklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356055875 PECOS PAC ID: 4385092881 Enrollment ID: I20231121003883 |
| Provider Name | Summer D Berry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841826559 PECOS PAC ID: 4688038961 Enrollment ID: I20231219003194 |
| Provider Name | Daniel R Barden |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780993048 PECOS PAC ID: 8921458753 Enrollment ID: I20231220001102 |
| Provider Name | Bill Owenby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851685952 PECOS PAC ID: 9234592718 Enrollment ID: I20240102002609 |
| Provider Name | Chang Lee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245644558 PECOS PAC ID: 1052775764 Enrollment ID: I20240115000598 |
| Provider Name | Norma Fernandez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518186618 PECOS PAC ID: 9234581281 Enrollment ID: I20240116001787 |
| Provider Name | Clayton Black |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033624317 PECOS PAC ID: 6709230014 Enrollment ID: I20240122001434 |
Nancy E Campbell, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2230 E. Speedway Blvd., Suite 100, Tucson, AZ 85719 Phone: 520-878-7857 Fax: 520-572-2049 | |
Counterpoint Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1661 N Swan Rd Ste 200-2, Tucson, AZ 85712 Phone: 520-990-3122 | |
Psyche Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5240 E Knight Dr Ste 120, Tucson, AZ 85712 Phone: 520-795-0309 Fax: 520-795-2030 | |
Counseling Directions Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 N Alvernon Way Ste 105, Tucson, AZ 85711 Phone: 520-561-8773 | |
Perception Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1213 E Warehouse Avenue, Tucson, AZ 85719 Phone: 520-623-7077 | |
B. Robert Crago Phd Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5363 E Pima St Ste 100, Tucson, AZ 85712 Phone: 520-323-0062 Fax: 520-323-1336 | |
Catalina Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 16358 N Forecastle Ave, Tucson, AZ 85739 Phone: 602-367-9807 |