| Selah Counseling Center Llc | |
|
2445 E Cheryl Dr Phoenix AZ 85028-4316 | |
| (623) 499-3218 | |
| Not Available |
| Full Name | Selah Counseling Center Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2445 E Cheryl Dr, Phoenix, Arizona |
| Authorized Official Name and Position | Jennifer Billiard (OWNER) |
| Authorized Official Contact | 6234993218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Selah Counseling Center Llc 2445 E Cheryl Dr Phoenix AZ 85028-4316 Ph: (623) 499-3218 | Selah Counseling Center Llc 2445 E Cheryl Dr Phoenix AZ 85028-4316 Ph: (623) 499-3218 |
| NPI Number | 1518633650 |
|---|---|
| Provider Enumeration Date | 08/18/2021 |
| Last Update Date | 08/18/2021 |
| Certification Date | 08/18/2021 |
| Medicare PECOS PAC ID | 6507264348 |
|---|---|
| Medicare Enrollment ID | O20211008002535 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518633650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer I Billiard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750837050 PECOS PAC ID: 4385922541 Enrollment ID: I20161024001508 |
| Provider Name | Shannon Kris Jacobson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225510688 PECOS PAC ID: 0648691881 Enrollment ID: I20200526002977 |
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