| Northlight Counseling Associates Inc | |
|
4121 E Valley Auto Dr Suite 122 Mesa AZ 85206-4631 | |
| (602) 285-9696 | |
| (602) 277-5930 |
| Full Name | Northlight Counseling Associates Inc |
|---|---|
| Speciality | Counselor |
| Location | 4121 E Valley Auto Dr, Mesa, Arizona |
| Authorized Official Name and Position | Stacy Cloyd (SECRETARY) |
| Authorized Official Contact | 9046054986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northlight Counseling Associates Inc 4121 E Valley Auto Dr. Suite 122 Mesa AZ 85206-4631 Ph: (602) 285-9696 | Northlight Counseling Associates Inc 4121 E Valley Auto Dr Suite 122 Mesa AZ 85206-4631 Ph: (602) 285-9696 |
| NPI Number | 1912943903 |
|---|---|
| Provider Enumeration Date | 06/20/2006 |
| Last Update Date | 07/25/2023 |
| Certification Date | 07/25/2023 |
| Medicare PECOS PAC ID | 3072590603 |
|---|---|
| Medicare Enrollment ID | O20040701001084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912943903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Randy Jon Brazie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740493428 PECOS PAC ID: 4688664188 Enrollment ID: I20040517000371 |
| Provider Name | Michael C Rockwell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083655195 PECOS PAC ID: 3971572868 Enrollment ID: I20061102000596 |
| Provider Name | Lovilla V Henkelman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629013396 PECOS PAC ID: 8325196025 Enrollment ID: I20090507000403 |
| Provider Name | Stephen D Bailey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255578324 PECOS PAC ID: 1557257847 Enrollment ID: I20101214000680 |
| Provider Name | Javier F Perez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922035625 PECOS PAC ID: 2860433075 Enrollment ID: I20120104000840 |
| Provider Name | Nellie Idara Samuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821344557 PECOS PAC ID: 1759642044 Enrollment ID: I20180301000886 |
| Provider Name | April Lucas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366471963 PECOS PAC ID: 0547522344 Enrollment ID: I20180314001201 |
| Provider Name | Nikka Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962939454 PECOS PAC ID: 4082040928 Enrollment ID: I20210819003588 |
| Provider Name | Cynthia Flores Cruz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659965390 PECOS PAC ID: 8426454703 Enrollment ID: I20210913000982 |
| Provider Name | Kia A Watkins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346991700 PECOS PAC ID: 7719371897 Enrollment ID: I20220307001810 |
| Provider Name | Joanna L Lensch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770225328 PECOS PAC ID: 3779942107 Enrollment ID: I20230703002623 |
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