| Queen Creek Counseling Llc | |
|
21321 E Ocotillo Rd B-105 Queen Creek AZ 85142-5996 | |
| (480) 258-2915 | |
| (480) 888-0231 |
| Full Name | Queen Creek Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 21321 E Ocotillo Rd, Queen Creek, Arizona |
| Authorized Official Name and Position | Pamela Carol Dean (OWNER) |
| Authorized Official Contact | 4802582915 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Queen Creek Counseling Llc Po Box 1598 Queen Creek AZ 85142-1835 Ph: (480) 258-2915 | Queen Creek Counseling Llc 21321 E Ocotillo Rd B-105 Queen Creek AZ 85142-5996 Ph: (480) 258-2915 |
| NPI Number | 1033441514 |
|---|---|
| Provider Enumeration Date | 02/08/2010 |
| Last Update Date | 02/08/2010 |
| Medicare PECOS PAC ID | 9739224502 |
|---|---|
| Medicare Enrollment ID | O20100304000137 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033441514 | NPI | - | NPPES |
| 752586 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-2854 (Arizona) | Primary |
| Provider Name | Pamela C Dean |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679650162 PECOS PAC ID: 1153493259 Enrollment ID: I20080707000635 |
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