| Wendy Chandross Cisw Pc | |
|
18205 N 51st Ave Building 2, Suite 115 Glendale AZ 85308-1490 | |
| (602) 571-1978 | |
| (602) 548-1446 |
| Full Name | Wendy Chandross Cisw Pc |
|---|---|
| Speciality | Social Worker |
| Location | 18205 N 51st Ave, Glendale, Arizona |
| Authorized Official Name and Position | Wendy Chandross (PRESIDENT) |
| Authorized Official Contact | 6025711978 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wendy Chandross Cisw Pc 21001 N Tatum Blvd Suite 1630-190 Phoenix AZ 85050-4206 Ph: (602) 571-1978 | Wendy Chandross Cisw Pc 18205 N 51st Ave Building 2, Suite 115 Glendale AZ 85308-1490 Ph: (602) 571-1978 |
| NPI Number | 1245410257 |
|---|---|
| Provider Enumeration Date | 11/07/2007 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 9537195896 |
|---|---|
| Medicare Enrollment ID | O20050709000072 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245410257 | NPI | - | NPPES |
| 944307 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 10960 (Arizona) | Primary |
| Provider Name | Wendy H Chandross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669579603 PECOS PAC ID: 1355377615 Enrollment ID: I20050709000074 |
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