| Gilbert Counselors, Llc | |
|
1425 W Elliot Rd Ste 201 Gilbert AZ 85233-5142 | |
| (480) 223-0225 | |
| (480) 505-7061 |
| Full Name | Gilbert Counselors, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1425 W Elliot Rd Ste 201, Gilbert, Arizona |
| Authorized Official Name and Position | Julia Spain (OWNER) |
| Authorized Official Contact | 6026971023 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gilbert Counselors, Llc 1425 W Elliot Rd Ste 201 Gilbert AZ 85233-5142 Ph: (480) 223-0225 | Gilbert Counselors, Llc 1425 W Elliot Rd Ste 201 Gilbert AZ 85233-5142 Ph: (480) 223-0225 |
| NPI Number | 1366947558 |
|---|---|
| Provider Enumeration Date | 03/28/2018 |
| Last Update Date | 01/02/2024 |
| Certification Date | 01/02/2024 |
| Medicare PECOS PAC ID | 7416393335 |
|---|---|
| Medicare Enrollment ID | O20240313002190 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366947558 | NPI | - | NPPES |
| 1205932936 | Other | AZ | PRIVATE PRACTICE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LPC11141 (Arizona) | Primary |
| Provider Name | Terri Jean Roman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124216247 PECOS PAC ID: 8325484249 Enrollment ID: I20240313002240 |
| Provider Name | Brina Lynn Henry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083254379 PECOS PAC ID: 5890132070 Enrollment ID: I20240322004059 |
| Provider Name | Dana Vandam |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144006768 PECOS PAC ID: 6103263298 Enrollment ID: I20240325003459 |
| Provider Name | Alicia Tequida |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356981864 PECOS PAC ID: 1153760368 Enrollment ID: I20240422000852 |
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