Community Intervention Associates - Medicare Mental Health Clinic in Bisbee, AZ

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Community Intervention Associates is a medicare enrolled mental health clinic (Community/behavioral Health) in Bisbee, Arizona. The current practice location for Community Intervention Associates is 1326 Hwy 92, Suite J, Bisbee, Arizona. For appointments, you can reach them via phone at (520) 366-3603. The mailing address for Community Intervention Associates is 2851 S Avenue B, Bldg 4, Yuma, Arizona and phone number is (928) 376-0026.

Community Intervention Associates is licensed to practice in Arizona (license number BH-3770). The clinic also participates in the medicare program and its NPI number is 1518250620. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (520) 366-3603.

Contact Information

Community Intervention Associates
1326 Hwy 92
Suite J
Bisbee
AZ 85603-0000
(520) 366-3603
(520) 432-3678

Map and Direction


Mental Health Clinic Profile

Full NameCommunity Intervention Associates
SpecialityCommunity/Behavioral Health
Location1326 Hwy 92, Bisbee, Arizona
Authorized Official Name and PositionFred R Cogburn (CEO)
Authorized Official Contact9283760026
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Community Intervention Associates
2851 S Avenue B
Bldg 4
Yuma
AZ 85364-7726

Ph: (928) 376-0026		Community Intervention Associates
1326 Hwy 92
Suite J
Bisbee
AZ 85603-0000

Ph: (520) 366-3603

NPI Details:

NPI Number1518250620
Provider Enumeration Date05/23/2011
Last Update Date08/28/2013

Medicare PECOS Information:

Medicare PECOS PAC ID4880851971
Medicare Enrollment IDO20120201000213

Medical Identifiers

Medical identifiers for Community Intervention Associates such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1518250620NPI-NPPES
620609MedicaidAZ

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
251S00000XCommunity/behavioral Health BH-3770 (Arizona)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Community Intervention Associates acts as a billing entity for following providers:
Provider NameRichelle Ramirez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396817862
PECOS PAC ID: 2062451750
Enrollment ID: I20050502001197
Provider NameVincent Krasevic
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1437259074
PECOS PAC ID: 6002816998
Enrollment ID: I20061227000094
Provider NameAntonio I Fernandez
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1023181377
PECOS PAC ID: 9739283292
Enrollment ID: I20070323000020
Provider NameSalvador Alonzo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396945994
PECOS PAC ID: 8729171996
Enrollment ID: I20070904000323
Provider NameJames D Mcdaniel
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1982794160
PECOS PAC ID: 7012075799
Enrollment ID: I20081024000096
Provider NameKane D Gronback
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356789226
PECOS PAC ID: 2264676758
Enrollment ID: I20130924000402
Provider NameElizabeth A Ruiz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477983229
PECOS PAC ID: 5496988636
Enrollment ID: I20140423002407
Provider NameRobin L Ross
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1629101217
PECOS PAC ID: 7911043252
Enrollment ID: I20150307000288
Provider NameEric Betancourt
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578945572
PECOS PAC ID: 5698089795
Enrollment ID: I20150803002646
Provider NameDaniela Reid
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1053467571
PECOS PAC ID: 5092746529
Enrollment ID: I20150909002582
Provider NameKelly L Mullins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083092100
PECOS PAC ID: 8325349285
Enrollment ID: I20151217002268
Provider NameDawn J Domenech
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093171456
PECOS PAC ID: 2163728916
Enrollment ID: I20160304001221
Provider NameShannon L Meyers
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174923585
PECOS PAC ID: 0143442566
Enrollment ID: I20160404000958
Provider NameGloria O'neill
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1407232663
PECOS PAC ID: 2567760523
Enrollment ID: I20160407002229
Provider NameGeorgina Rotzler
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174937379
PECOS PAC ID: 7214156074
Enrollment ID: I20160606001856
Provider NameAmy Melissa Porter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528515814
PECOS PAC ID: 2961779368
Enrollment ID: I20170606000239
Provider NameGabriel P Lindstrom
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518316983
PECOS PAC ID: 7618234758
Enrollment ID: I20171128003413
Provider NameBarbara Ann Rahman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972685022
PECOS PAC ID: 8729030861
Enrollment ID: I20180116002139
Provider NameKami Simmons
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518486018
PECOS PAC ID: 6305103268
Enrollment ID: I20180328001894
Provider NameLisa Ling
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801299078
PECOS PAC ID: 6103188271
Enrollment ID: I20180329002360
Provider NamePatrick E Hickey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699746099
PECOS PAC ID: 7012938806
Enrollment ID: I20180626002848
Provider NameDelores A Walker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346346657
PECOS PAC ID: 0244388890
Enrollment ID: I20180627003897
Provider NameLupe S Contreras
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588830749
PECOS PAC ID: 3577605096
Enrollment ID: I20180725000805
Provider NameCharles Christian Kohnken
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306399027
PECOS PAC ID: 2961799192
Enrollment ID: I20180903000080
Provider NameOyeronke Omoyeni Ajiboye-lala
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1073920203
PECOS PAC ID: 9032331202
Enrollment ID: I20181126001683
Provider NameAngel M Rivers
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730605890
PECOS PAC ID: 7416214465
Enrollment ID: I20190808000893
Provider NameAmanda L Bunch
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245796069
PECOS PAC ID: 6709118482
Enrollment ID: I20200819004211
Provider NameLyntressa Danielle Grant
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083955793
PECOS PAC ID: 3375784911
Enrollment ID: I20200904001767
Provider NameTheresa T Nguyen
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1679884928
PECOS PAC ID: 0648603233
Enrollment ID: I20201007002815
Provider NameKassidi Bremer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1962897173
PECOS PAC ID: 1658691126
Enrollment ID: I20210120002002
Provider NameFolashade Sobande-amon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841836624
PECOS PAC ID: 2466866041
Enrollment ID: I20210121001943
Provider NameKathleen Shemberger
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467047308
PECOS PAC ID: 7012325129
Enrollment ID: I20210408002775
Provider NameMosunmola Ogunyinmi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205495165
PECOS PAC ID: 3375945454
Enrollment ID: I20210712003661
Provider NameOzioma Anyakudo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992337257
PECOS PAC ID: 0143651117
Enrollment ID: I20210720003296
Provider NameFunmilayo Akintunde
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1437797842
PECOS PAC ID: 6507272028
Enrollment ID: I20211101002420
Provider NameCharity Lynn O'leary-taylor
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396225082
PECOS PAC ID: 2860887361
Enrollment ID: I20220321000281
Provider NameElizabeth Adeshola
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740950898
PECOS PAC ID: 6901275411
Enrollment ID: I20221205002981
Provider NameSurat J Ibrahim
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659013332
PECOS PAC ID: 3274902705
Enrollment ID: I20221206000540
Provider NameDevon M Gomperts
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558914507
PECOS PAC ID: 8325463615
Enrollment ID: I20230502000849
Provider NameSusan Solstice
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1871355784
PECOS PAC ID: 4183064058
Enrollment ID: I20240426000181
Provider NameWalter Tucker
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1609279108
PECOS PAC ID: 2860832532
Enrollment ID: I20240429000565
Provider NameShawn Backs
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1497293880
PECOS PAC ID: 2062853112
Enrollment ID: I20240507004249

Reviews and Comments

Community/Behavioral Health in Bisbee, AZ

Pinal Hispanic Council
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1326 W Highway 92 Ste J, Bisbee, AZ 85603
Phone: 520-366-3603    Fax: 520-432-3678
Arizona Counseling & Treatment Services, L.l.c.
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: #24 Howell St., Bisbee, AZ 85603
Phone: 928-376-0220    Fax: 928-376-0709
Arizona Counseling & Treatment Services, L.l.c.
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 400 Arizona St, Bisbee, AZ 85603
Phone: 928-376-0220    Fax: 928-376-0709
Miracles Of A Second Chance Inc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 507 19th Ter, Bisbee, AZ 85603
Phone: 520-255-2158    
Boys & Girls Club Of Bisbee,az,inc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 405 Arizona St, Bisbee, AZ 85603
Phone: 520-432-3010    Fax: 520-432-6903

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.