| Havasu Behavioral Health, Llc | |
|
1695 Mesquite Ave Ste 216 Lake Havasu City AZ 86403-5688 | |
| (928) 453-0404 | |
| Not Available |
| Full Name | Havasu Behavioral Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1695 Mesquite Ave Ste 216, Lake Havasu City, Arizona |
| Authorized Official Name and Position | Kimberly Walker (LCSW) |
| Authorized Official Contact | 9284530404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Havasu Behavioral Health, Llc 1695 Mesquite Ave Ste 216 Lake Havasu City AZ 86403-5688 Ph: (928) 453-0404 | Havasu Behavioral Health, Llc 1695 Mesquite Ave Ste 216 Lake Havasu City AZ 86403-5688 Ph: (928) 453-0404 |
| NPI Number | 1033764097 |
|---|---|
| Provider Enumeration Date | 08/07/2019 |
| Last Update Date | 05/20/2024 |
| Certification Date | 05/20/2024 |
| Medicare PECOS PAC ID | 3971945767 |
|---|---|
| Medicare Enrollment ID | O20240524001048 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033764097 | NPI | - | NPPES |
| Provider Name | Larry D Lumpkin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922023621 PECOS PAC ID: 6709853880 Enrollment ID: I20040916001097 |
| Provider Name | Kimberly Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215622931 PECOS PAC ID: 0840642906 Enrollment ID: I20240528002644 |
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