| Integrative Counseling Center (icc) | |
|
11811 N Tatum Blvd Ste 3031 Phoenix AZ 85028-1621 | |
| (773) 706-8981 | |
| Not Available |
| Full Name | Integrative Counseling Center (icc) |
|---|---|
| Speciality | Counselor |
| Location | 11811 N Tatum Blvd Ste 3031, Phoenix, Arizona |
| Authorized Official Name and Position | Daniel Levi (OWNER, CLINICAL DIRECTOR) |
| Authorized Official Contact | 7737068981 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Counseling Center (icc) 6730 E Pershing Ave Scottsdale AZ 85254-3941 Ph: (480) 216-3276 | Integrative Counseling Center (icc) 11811 N Tatum Blvd Ste 3031 Phoenix AZ 85028-1621 Ph: (773) 706-8981 |
| NPI Number | 1275025314 |
|---|---|
| Provider Enumeration Date | 06/05/2018 |
| Last Update Date | 02/09/2023 |
| Certification Date | 02/02/2023 |
| Medicare PECOS PAC ID | 1355789181 |
|---|---|
| Medicare Enrollment ID | O20240329000843 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275025314 | NPI | - | NPPES |
| Provider Name | Daniel Charles Levi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124579446 PECOS PAC ID: 3173961901 Enrollment ID: I20240401000630 |
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