| Reconnect Counseling Of Arizona, Llc | |
|
1447 W Elliot Rd Ste 103 Gilbert AZ 85233-5166 | |
| (602) 741-8537 | |
| (480) 892-4640 |
| Full Name | Reconnect Counseling Of Arizona, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1447 W Elliot Rd Ste 103, Gilbert, Arizona |
| Authorized Official Name and Position | Rebecca Van Wagenen Bermudez (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6027418537 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reconnect Counseling Of Arizona, Llc 122 S Nevada Way Gilbert AZ 85233-4707 Ph: (602) 741-8537 | Reconnect Counseling Of Arizona, Llc 1447 W Elliot Rd Ste 103 Gilbert AZ 85233-5166 Ph: (602) 741-8537 |
| NPI Number | 1184107096 |
|---|---|
| Provider Enumeration Date | 09/07/2018 |
| Last Update Date | 09/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184107096 | NPI | - | NPPES |
| 14310600 | Other | AZ | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 12320 (Arizona) | Primary |
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