| Stefanny Balestracci | |
|
10211 N 32nd St Ste E1 Phoenix AZ 85028-3845 | |
| (602) 698-5777 | |
| Not Available |
| Full Name | Stefanny Balestracci |
|---|---|
| Speciality | Counselor |
| Location | 10211 N 32nd St Ste E1, Phoenix, Arizona |
| Authorized Official Name and Position | Stefanny Balestracci (OWNER) |
| Authorized Official Contact | 6023634884 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stefanny Balestracci 10211 N 32nd St Ste E1 Phoenix AZ 85028-3845 Ph: (602) 698-5777 | Stefanny Balestracci 10211 N 32nd St Ste E1 Phoenix AZ 85028-3845 Ph: (602) 698-5777 |
| NPI Number | 1104523448 |
|---|---|
| Provider Enumeration Date | 02/07/2023 |
| Last Update Date | 04/11/2024 |
| Certification Date | 04/11/2024 |
| Medicare PECOS PAC ID | 0345681136 |
|---|---|
| Medicare Enrollment ID | O20240510001101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104523448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Stefanny Balestracci |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831732874 PECOS PAC ID: 2163863952 Enrollment ID: I20240510001255 |
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