| Dedicated Onsite Therapy Llc | |
|
4340 E Indian School Rd Ste 21-550 Phoenix AZ 85018-9300 | |
| (408) 644-7443 | |
| (602) 314-7223 |
| Full Name | Dedicated Onsite Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4340 E Indian School Rd Ste 21-550, Phoenix, Arizona |
| Authorized Official Name and Position | Cameron Marshall (PRESIDENT) |
| Authorized Official Contact | 4086447443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dedicated Onsite Therapy Llc Po Box 5561 Phoenix AZ 85010-5561 Ph: (602) 224-9790 | Dedicated Onsite Therapy Llc 4340 E Indian School Rd Ste 21-550 Phoenix AZ 85018-9300 Ph: (408) 644-7443 |
| NPI Number | 1487336442 |
|---|---|
| Provider Enumeration Date | 08/01/2023 |
| Last Update Date | 08/01/2023 |
| Certification Date | 07/26/2023 |
| Medicare PECOS PAC ID | 5698139103 |
|---|---|
| Medicare Enrollment ID | O20230918001905 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487336442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Stacy Beth Adler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568568830 PECOS PAC ID: 1355674268 Enrollment ID: I20190607002530 |
| Provider Name | Debra W Gold |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457915316 PECOS PAC ID: 1355734732 Enrollment ID: I20220207002250 |
| Provider Name | Deborah Mack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124648175 PECOS PAC ID: 4486039278 Enrollment ID: I20220914003249 |
| Provider Name | Ginka Conrey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619481132 PECOS PAC ID: 0244694669 Enrollment ID: I20230918002601 |
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