| Mental Health Wellness Boutique | |
|
18001 N 79th Ave Ste B48 Glendale AZ 85308-8393 | |
| (888) 906-8301 | |
| (623) 404-6602 |
| Full Name | Mental Health Wellness Boutique |
|---|---|
| Speciality | Clinic/Center |
| Location | 18001 N 79th Ave Ste B48, Glendale, Arizona |
| Authorized Official Name and Position | Irina Ashamalla (CEO) |
| Authorized Official Contact | 8889068301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Wellness Boutique 18001 N 79th Ave Ste B48 Glendale AZ 85308-8393 Ph: (888) 906-8301 | Mental Health Wellness Boutique 18001 N 79th Ave Ste B48 Glendale AZ 85308-8393 Ph: (888) 906-8301 |
| NPI Number | 1972266757 |
|---|---|
| Provider Enumeration Date | 10/18/2021 |
| Last Update Date | 08/11/2024 |
| Certification Date | 08/11/2024 |
| Medicare PECOS PAC ID | 6709272479 |
|---|---|
| Medicare Enrollment ID | O20220405002346 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972266757 | NPI | - | NPPES |
| 1205365772 | Other | AZ | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Irina Ashamalla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205365772 PECOS PAC ID: 5698032449 Enrollment ID: I20171201002914 |
A New Leaf Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8581 N 61st Ave Bldg A, Glendale, AZ 85302 Phone: 623-934-1991 Fax: 623-878-9335 | |
Enhance Counseling & Wellness Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 17431 N 71st Dr Ste 101, Glendale, AZ 85308 Phone: 623-680-3469 Fax: 623-248-3389 | |
Center For Couples Therapy, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18205 N 51st Ave, Ste 113, Glendale, AZ 85308 Phone: 623-999-7368 | |
Brown Behavioral Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7900 N 70th Ave Ste 102, Glendale, AZ 85303 Phone: 623-302-4009 | |
Family Life Behavioral Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6610 N 47th Ave Ste 4, Glendale, AZ 85301 Phone: 623-206-7541 | |
Healing Hartze Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 17505 N 79th Ave Ste 105, Glendale, AZ 85308 Phone: 602-989-8899 Fax: 602-900-0969 | |
2nd Chance Behavioral Health Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10620 N 43rd Ave Ste 10, Glendale, AZ 85304 Phone: 602-860-0044 Fax: 602-848-3186 |