| Sea Glass Mental Health Inc | |
|
7420 E Camelback Rd Ste 101 Scottsdale AZ 85251-3509 | |
| (480) 256-2605 | |
| Not Available |
| Full Name | Sea Glass Mental Health Inc |
|---|---|
| Speciality | Counselor |
| Location | 7420 E Camelback Rd Ste 101, Scottsdale, Arizona |
| Authorized Official Name and Position | Jaena Abarzua (PRESIDENT) |
| Authorized Official Contact | 6232381616 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sea Glass Mental Health Inc 111 Hekili St Ste A241 Kailua HI 96734-2800 Ph: (623) 238-1616 | Sea Glass Mental Health Inc 7420 E Camelback Rd Ste 101 Scottsdale AZ 85251-3509 Ph: (480) 256-2605 |
| NPI Number | 1417688821 |
|---|---|
| Provider Enumeration Date | 06/17/2022 |
| Last Update Date | 04/06/2023 |
| Certification Date | 04/06/2023 |
| Medicare PECOS PAC ID | 0547643959 |
|---|---|
| Medicare Enrollment ID | O20240319002056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417688821 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Jaena Kae Abarzua |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316405939 PECOS PAC ID: 1456734862 Enrollment ID: I20240319002210 |
| Provider Name | Pamela Jean Wagner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982316972 PECOS PAC ID: 3870930233 Enrollment ID: I20240320002849 |
| Provider Name | Aubrey Ann Nelson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881325389 PECOS PAC ID: 4284072612 Enrollment ID: I20240404002408 |
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