| Paramount Behavioral Health Services Pllc | |
|
1631 W Burnside Trl Phoenix AZ 85085-8071 | |
| (623) 225-6220 | |
| (623) 518-2349 |
| Full Name | Paramount Behavioral Health Services Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1631 W Burnside Trl, Phoenix, Arizona |
| Authorized Official Name and Position | Elise Ballou (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6232256220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paramount Behavioral Health Services Pllc Po Box 10727 Glendale AZ 85318-0727 Ph: (623) 225-6220 | Paramount Behavioral Health Services Pllc 1631 W Burnside Trl Phoenix AZ 85085-8071 Ph: (623) 225-6220 |
| NPI Number | 1366941361 |
|---|---|
| Provider Enumeration Date | 02/05/2018 |
| Last Update Date | 11/16/2020 |
| Certification Date | 11/16/2020 |
| Medicare PECOS PAC ID | 4880957463 |
|---|---|
| Medicare Enrollment ID | O20180412001364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366941361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 45661 (Arizona) | Primary |
| 363A00000X | Physician Assistant | 4900 (Arizona) | Secondary |
| Provider Name | Sarah E Wicklund |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629241179 PECOS PAC ID: 1850424425 Enrollment ID: I20120810000260 |
| Provider Name | Ifeanyi C Willson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801290051 PECOS PAC ID: 9830409143 Enrollment ID: I20151116002629 |
| Provider Name | Courtney J Mullins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831342989 PECOS PAC ID: 6305281155 Enrollment ID: I20240301003710 |
| Provider Name | Zackary T Paustian |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407279417 PECOS PAC ID: 1759727803 Enrollment ID: I20240311003879 |
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