| Dynamic Counseling And Coaching Solutions, Llc | |
|
13201 N 35th Ave Ste 5b Phoenix AZ 85029-1231 | |
| (602) 777-1268 | |
| (866) 251-5468 |
| Full Name | Dynamic Counseling And Coaching Solutions, Llc |
|---|---|
| Speciality | Counselor |
| Location | 13201 N 35th Ave Ste 5b, Phoenix, Arizona |
| Authorized Official Name and Position | Erica Shumate Sims (CEO) |
| Authorized Official Contact | 6027771268 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Counseling And Coaching Solutions, Llc 24654 N Lake Pleasant Pkwy # 103-328 Peoria AZ 85383-1359 Ph: (602) 777-1268 | Dynamic Counseling And Coaching Solutions, Llc 13201 N 35th Ave Ste 5b Phoenix AZ 85029-1231 Ph: (602) 777-1268 |
| NPI Number | 1417470287 |
|---|---|
| Provider Enumeration Date | 07/24/2017 |
| Last Update Date | 03/01/2019 |
| Medicare PECOS PAC ID | 0446694756 |
|---|---|
| Medicare Enrollment ID | O20240214003183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417470287 | NPI | - | NPPES |
| 1891248381 | Other | AZ | NPI |
| 230114 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LPC-15992 (Arizona) | Secondary |
| 101YP2500X | Counselor - Professional | LPC-15992 (Arizona) | Primary |
| Provider Name | Erica Shumate Sims |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891248381 PECOS PAC ID: 5991149205 Enrollment ID: I20240215002984 |
| Provider Name | Stacie Ann Townsend |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467799015 PECOS PAC ID: 5294170023 Enrollment ID: I20240301003226 |
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