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3303 E Baseline Rd Gilbert AZ 85234-2738 | |
| (801) 655-5450 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 3303 E Baseline Rd, Gilbert, Arizona |
| Authorized Official Name and Position | Whitney Hebbert (OWNER) |
| Authorized Official Contact | 8016555450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1469 N 1200 W Orem UT 84057-2449 Ph: () - | 3303 E Baseline Rd Gilbert AZ 85234-2738 Ph: (801) 655-5450 |
| NPI Number | 1669251120 |
|---|---|
| Provider Enumeration Date | 09/25/2023 |
| Last Update Date | 08/06/2024 |
| Certification Date | 08/06/2024 |
| Medicare PECOS PAC ID | 1456885763 |
|---|---|
| Medicare Enrollment ID | O20241108002901 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669251120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Shelby Schiller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326566969 PECOS PAC ID: 3779845128 Enrollment ID: I20230901002283 |
| Provider Name | Michele Mitchell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528614757 PECOS PAC ID: 4385087766 Enrollment ID: I20240213003023 |
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