| |
1500 N Priest Drive 109 Tempe AZ 85288-1213 | |
(702) 589-4871 | |
(702) 589-4872 |
Full Name | |
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Speciality | Psychiatry & Neurology |
Location | 1500 N Priest Drive, Tempe, Arizona |
Authorized Official Name and Position | Jennifer Williamson (CREDENTIALING SUPERVISOR) |
Authorized Official Contact | 7073496919 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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275 E Rivulon Blvd Ste 201 Gilbert AZ 85297-0008 Ph: (602) 734-5664 | 1500 N Priest Drive 109 Tempe AZ 85288-1213 Ph: (702) 589-4871 |
NPI Number | 1932560729 |
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Provider Enumeration Date | 03/08/2016 |
Last Update Date | 07/13/2022 |
Certification Date | 07/13/2022 |
Medicare PECOS PAC ID | 9335430693 |
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Medicare Enrollment ID | O20160617000240 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932560729 | NPI | - | NPPES |
143931 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Lynn M Klimo |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1184669921 PECOS PAC ID: 4385531623 Enrollment ID: I20120919000862 |
Provider Name | Roy Lee Evans |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578583209 PECOS PAC ID: 8426108481 Enrollment ID: I20140428000003 |
Provider Name | Ana L Mcnabb |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679945174 PECOS PAC ID: 0749583342 Enrollment ID: I20160114001002 |
Provider Name | Ramiz Audi |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1467659193 PECOS PAC ID: 4385967587 Enrollment ID: I20171113003321 |
Provider Name | Michelle C James |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1841702743 PECOS PAC ID: 8921366535 Enrollment ID: I20180102002535 |
Provider Name | Kimberlee V Wilson |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1306134929 PECOS PAC ID: 3678890563 Enrollment ID: I20200921001540 |
Provider Name | Tiffany Marie Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518444041 PECOS PAC ID: 7012259708 Enrollment ID: I20210517001219 |
Provider Name | Anthony Quinn |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1558621151 PECOS PAC ID: 0547489619 Enrollment ID: I20210527001939 |
Provider Name | Sarita Vijay |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205569910 PECOS PAC ID: 3678958758 Enrollment ID: I20220912000602 |
Provider Name | Meredith Johnson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578286431 PECOS PAC ID: 8123496890 Enrollment ID: I20221130002238 |
Provider Name | Brian Berrett |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1396107595 PECOS PAC ID: 6103104815 Enrollment ID: I20230203002550 |
Provider Name | Marie Grace De Leon |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942990593 PECOS PAC ID: 0042676801 Enrollment ID: I20230520000044 |
Provider Name | Martin Ngu Kwale Pong |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245935204 PECOS PAC ID: 3476911942 Enrollment ID: I20230615002989 |
Provider Name | Bernice Ohene |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073007126 PECOS PAC ID: 1951642644 Enrollment ID: I20230707003187 |
Provider Name | Kinner Echeche Atekwane |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093420374 PECOS PAC ID: 1557749173 Enrollment ID: I20230724002023 |
Provider Name | Melissa Bolt |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730374547 PECOS PAC ID: 6901290618 Enrollment ID: I20231011003278 |
Provider Name | Kara Masters |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770263642 PECOS PAC ID: 2961857883 Enrollment ID: I20231012003497 |
Provider Name | Maceline Check Check |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821795626 PECOS PAC ID: 6800242983 Enrollment ID: I20231025002870 |
Provider Name | Felicia D Thomas |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1134801053 PECOS PAC ID: 2961855283 Enrollment ID: I20240201004273 |
Provider Name | Megan C Segraves |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1396410304 PECOS PAC ID: 1557714995 Enrollment ID: I20240215002140 |
Provider Name | Carrie Mardula |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1164177739 PECOS PAC ID: 6204271364 Enrollment ID: I20240228002423 |
Provider Name | Kevin P Schulte |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235911355 PECOS PAC ID: 8729425632 Enrollment ID: I20240327000210 |
Provider Name | Alana Engel |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1184219263 PECOS PAC ID: 0244779320 Enrollment ID: I20240903003977 |
Provider Name | Eva C Gillespie |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417650813 PECOS PAC ID: 2769922871 Enrollment ID: I20240904001521 |
Provider Name | Carrianne Connors |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1760848485 PECOS PAC ID: 7012440100 Enrollment ID: I20241028003316 |
Provider Name | Ginno Paolo De Leon |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528895182 PECOS PAC ID: 6204361140 Enrollment ID: I20241202000825 |
Skycrest Neurology, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 E Southern Ave, #d1, Tempe, AZ 85282 Phone: 480-219-7272 | |
Empact-suicide Prevention Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 618 S. Madison Drive, Tempe, AZ 85281 Phone: 480-784-1514 Fax: 480-967-3528 | |
Avira Behavioral Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 64 E Broadway Rd Ste 200, Tempe, AZ 85282 Phone: 346-500-4514 | |