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994 S Harrison Rd Tucson AZ 85748-6608 | |
| (520) 721-1887 | |
| (520) 721-0069 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 994 S Harrison Rd, Tucson, Arizona |
| Authorized Official Name and Position | Rose Mary Lopez (PRESIDENT AND CEO) |
| Authorized Official Contact | 5207211887 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 86537 Tucson AZ 85754-6537 Ph: (520) 721-1887 | 994 S Harrison Rd Tucson AZ 85748-6608 Ph: (520) 721-1887 |
| NPI Number | 1083846661 |
|---|---|
| Provider Enumeration Date | 08/17/2009 |
| Last Update Date | 10/09/2020 |
| Certification Date | 10/09/2020 |
| Medicare PECOS PAC ID | 5395023048 |
|---|---|
| Medicare Enrollment ID | O20161031002068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083846661 | NPI | - | NPPES |
| OTC5916 | Other | AZ | STATE LICENSE |
| 451145 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH3355 (Arizona) | Primary |
| Provider Name | Sylvia P Valenzuela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578822680 PECOS PAC ID: 6901052166 Enrollment ID: I20120803000764 |
| Provider Name | Ian Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417402280 PECOS PAC ID: 8820374911 Enrollment ID: I20170403002154 |
| Provider Name | Charles Christian Kohnken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306399027 PECOS PAC ID: 2961799192 Enrollment ID: I20180903000080 |
| Provider Name | Mosunmola Ogunyinmi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205495165 PECOS PAC ID: 3375945454 Enrollment ID: I20210712003661 |
| Provider Name | Seena Sunny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164283818 PECOS PAC ID: 7113362534 Enrollment ID: I20240226001203 |
| Provider Name | Joy-anne Simone James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205381498 PECOS PAC ID: 2567742380 Enrollment ID: I20240229003657 |
| Provider Name | Martin Romeo Tamou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114785953 PECOS PAC ID: 1456791748 Enrollment ID: I20240503001093 |
| Provider Name | Lisa M Lenius |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386130318 PECOS PAC ID: 8123561768 Enrollment ID: I20240624001958 |
| Provider Name | Peter Francis Tolhurst |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225554363 PECOS PAC ID: 6709321185 Enrollment ID: I20240710000255 |
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Counterpoint Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1661 N Swan Rd Ste 200-2, Tucson, AZ 85712 Phone: 520-990-3122 | |
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B. Robert Crago Phd Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5363 E Pima St Ste 100, Tucson, AZ 85712 Phone: 520-323-0062 Fax: 520-323-1336 | |