| Denova Collaborative Health, Llc | |
|
3330 N 2nd St Ste 601 Phoenix AZ 85012-2395 | |
| (602) 230-7373 | |
| (602) 682-7455 |
| Full Name | Denova Collaborative Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3330 N 2nd St Ste 601, Phoenix, Arizona |
| Authorized Official Name and Position | Graham Johnson (CEO) |
| Authorized Official Contact | 6022307373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Denova Collaborative Health, Llc 3101 N Central Ave Ste 500 Phoenix AZ 85012-2639 Ph: (602) 230-7373 | Denova Collaborative Health, Llc 3330 N 2nd St Ste 601 Phoenix AZ 85012-2395 Ph: (602) 230-7373 |
| NPI Number | 1609300854 |
|---|---|
| Provider Enumeration Date | 04/14/2017 |
| Last Update Date | 09/07/2023 |
| Medicare PECOS PAC ID | 2466437736 |
|---|---|
| Medicare Enrollment ID | O20040621001542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609300854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Gorky Herrera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740222025 PECOS PAC ID: 2860391638 Enrollment ID: I20031231000450 |
| Provider Name | Thomas Nathan Crumbley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831367457 PECOS PAC ID: 8628966231 Enrollment ID: I20040305001071 |
| Provider Name | Cathy J Kaplicki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033142666 PECOS PAC ID: 4486545803 Enrollment ID: I20040323001879 |
| Provider Name | Anne Marie Reed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275553927 PECOS PAC ID: 3971593062 Enrollment ID: I20040512000874 |
| Provider Name | Houshang Aminian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033164413 PECOS PAC ID: 1850364035 Enrollment ID: I20040816001302 |
| Provider Name | Edwin A Perez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376587816 PECOS PAC ID: 1456318625 Enrollment ID: I20041220000531 |
| Provider Name | Thomas David Gazda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730158189 PECOS PAC ID: 3375501620 Enrollment ID: I20050103000732 |
| Provider Name | Julius Chaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851394183 PECOS PAC ID: 1052362241 Enrollment ID: I20050204000396 |
| Provider Name | Michael L Vines |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881641272 PECOS PAC ID: 9830138544 Enrollment ID: I20050502000516 |
| Provider Name | Corey J Mayberger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386723195 PECOS PAC ID: 3274573530 Enrollment ID: I20050505000627 |
| Provider Name | Bruce R Holzman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407834997 PECOS PAC ID: 8325073398 Enrollment ID: I20050928000711 |
| Provider Name | Martin A Feldman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740272921 PECOS PAC ID: 3274551551 Enrollment ID: I20051104000375 |
| Provider Name | Joshua A Millstein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376749721 PECOS PAC ID: 5092816652 Enrollment ID: I20070726000170 |
| Provider Name | Patricia Bruce |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346426921 PECOS PAC ID: 6305929605 Enrollment ID: I20080211000098 |
| Provider Name | Kathleen J Brite |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356548226 PECOS PAC ID: 4688749237 Enrollment ID: I20080818000294 |
| Provider Name | Marisa A Valandra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902051071 PECOS PAC ID: 8527129790 Enrollment ID: I20081230000109 |
| Provider Name | Lynn M Nunemacher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790920882 PECOS PAC ID: 0446308233 Enrollment ID: I20090505000400 |
| Provider Name | Charlotte V Gurule |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770552598 PECOS PAC ID: 1850417882 Enrollment ID: I20100928000764 |
| Provider Name | Danielle R Sink |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952390833 PECOS PAC ID: 4183767114 Enrollment ID: I20100929000888 |
| Provider Name | Jon H Mccaine |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003064908 PECOS PAC ID: 7214110352 Enrollment ID: I20110325000835 |
| Provider Name | Kimberly F Carroll |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992757652 PECOS PAC ID: 9537331954 Enrollment ID: I20111007000180 |
| Provider Name | Monica Benavidez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710182225 PECOS PAC ID: 3678723913 Enrollment ID: I20121023000712 |
| Provider Name | Krista D Pellicore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235174731 PECOS PAC ID: 2264320290 Enrollment ID: I20131120001545 |
| Provider Name | Trisha S Tavares |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447461520 PECOS PAC ID: 8022102979 Enrollment ID: I20140306001036 |
| Provider Name | Rahsaan L Lindsey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245400928 PECOS PAC ID: 8123155710 Enrollment ID: I20150130001722 |
| Provider Name | Cynthia Stahura |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407247091 PECOS PAC ID: 4082931878 Enrollment ID: I20150314000352 |
| Provider Name | David E Nagata |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750371324 PECOS PAC ID: 3476549585 Enrollment ID: I20150730012870 |
| Provider Name | Arthur Lewis Pelberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285749424 PECOS PAC ID: 9234446964 Enrollment ID: I20150914001406 |
| Provider Name | Stephanie A Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912344656 PECOS PAC ID: 1850691544 Enrollment ID: I20151202001345 |
| Provider Name | Laura C Waddington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295010122 PECOS PAC ID: 3274836333 Enrollment ID: I20160122001414 |
| Provider Name | Christin M Salzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720445570 PECOS PAC ID: 5193024727 Enrollment ID: I20160503000367 |
| Provider Name | Barbara A Schulte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295184778 PECOS PAC ID: 3971896119 Enrollment ID: I20160725003030 |
| Provider Name | Joan Margaret Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023352952 PECOS PAC ID: 1557655875 Enrollment ID: I20160810000456 |
| Provider Name | Faraz Masood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215041744 PECOS PAC ID: 6406927219 Enrollment ID: I20161025001873 |
| Provider Name | Misbah W Altaf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790917052 PECOS PAC ID: 7315199114 Enrollment ID: I20161130002339 |
| Provider Name | Erika Oquendo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851764161 PECOS PAC ID: 3971884743 Enrollment ID: I20170110002297 |
| Provider Name | Nadia Ledesma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477006989 PECOS PAC ID: 9335421999 Enrollment ID: I20170117001139 |
| Provider Name | Kirsten A Powell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003350844 PECOS PAC ID: 0648554121 Enrollment ID: I20170228002442 |
| Provider Name | Alana Urness |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659810877 PECOS PAC ID: 1557646064 Enrollment ID: I20170324001178 |
| Provider Name | Stacy Jean Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922359462 PECOS PAC ID: 8325290638 Enrollment ID: I20170419002143 |
| Provider Name | Monica M Booth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457708638 PECOS PAC ID: 9739465071 Enrollment ID: I20170420002046 |
| Provider Name | Elizabeth Lyle Metzger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376072975 PECOS PAC ID: 0648549691 Enrollment ID: I20170706001950 |
| Provider Name | Kelsy Streeter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427586197 PECOS PAC ID: 2264701952 Enrollment ID: I20170712002092 |
| Provider Name | Marcus Fossmeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447773478 PECOS PAC ID: 0648543306 Enrollment ID: I20170831003308 |
| Provider Name | Clara E Krajnik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316398076 PECOS PAC ID: 6204100803 Enrollment ID: I20170920002821 |
| Provider Name | Shanytel M Weathersby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740605260 PECOS PAC ID: 4981900800 Enrollment ID: I20171218000898 |
| Provider Name | Alexis Nordvold-young Silence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174022628 PECOS PAC ID: 4789945148 Enrollment ID: I20180227001008 |
| Provider Name | Robert Murphy Portley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417299819 PECOS PAC ID: 6608137948 Enrollment ID: I20180228001970 |
| Provider Name | Augustin Harelimana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396253761 PECOS PAC ID: 1456614510 Enrollment ID: I20180427001661 |
| Provider Name | Laura Mancuso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699184432 PECOS PAC ID: 4183989536 Enrollment ID: I20180605003470 |
| Provider Name | Luis F Fong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598259467 PECOS PAC ID: 8729337936 Enrollment ID: I20180822000329 |
| Provider Name | Claudia Arballo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659866986 PECOS PAC ID: 8921350521 Enrollment ID: I20181009003645 |
| Provider Name | Margaret S Masi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871974931 PECOS PAC ID: 5698027217 Enrollment ID: I20181010000532 |
| Provider Name | Jessica Lynn Holliday |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356829626 PECOS PAC ID: 6507119153 Enrollment ID: I20181029000741 |
| Provider Name | Alyssa Emily Lewellen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336635937 PECOS PAC ID: 6204189749 Enrollment ID: I20181030001778 |
| Provider Name | Michelle Cator |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114401049 PECOS PAC ID: 1456605534 Enrollment ID: I20181107003054 |
| Provider Name | Donnette M Alexis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437308277 PECOS PAC ID: 4587901434 Enrollment ID: I20190130001860 |
| Provider Name | Mark Gregory Sonenschein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457816597 PECOS PAC ID: 5991046542 Enrollment ID: I20190408001778 |
| Provider Name | Jamil Marie Bayless |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952865610 PECOS PAC ID: 3072854462 Enrollment ID: I20190412000229 |
| Provider Name | Jamie Lynn Crumley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629532387 PECOS PAC ID: 3173856986 Enrollment ID: I20190611001375 |
| Provider Name | Rosine Ndayikeze Oriabure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083268874 PECOS PAC ID: 3274863105 Enrollment ID: I20190919001318 |
| Provider Name | Jacqueline Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295371342 PECOS PAC ID: 1557795358 Enrollment ID: I20200103001200 |
| Provider Name | Jennifer Beitel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124650429 PECOS PAC ID: 2163859554 Enrollment ID: I20200225000544 |
| Provider Name | Matthew Deise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760021885 PECOS PAC ID: 0749617843 Enrollment ID: I20200303000227 |
| Provider Name | Darcy Machado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578109211 PECOS PAC ID: 9931537479 Enrollment ID: I20200317001581 |
| Provider Name | Katherine M Bear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245863786 PECOS PAC ID: 5698105518 Enrollment ID: I20200416003362 |
| Provider Name | Dorothy A Alberti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518594662 PECOS PAC ID: 1557791308 Enrollment ID: I20200420001916 |
| Provider Name | David Elias Messer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982103172 PECOS PAC ID: 0345662292 Enrollment ID: I20200622002620 |
| Provider Name | Stephanie Price |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578097077 PECOS PAC ID: 6800219403 Enrollment ID: I20200714002623 |
| Provider Name | Eric Gee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548828619 PECOS PAC ID: 7618391723 Enrollment ID: I20200722002556 |
| Provider Name | Elizabeth P Mazhuvencherry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952928061 PECOS PAC ID: 4688091671 Enrollment ID: I20200908000683 |
| Provider Name | Judah Samuel David Rome |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144832916 PECOS PAC ID: 4981022944 Enrollment ID: I20200908003451 |
| Provider Name | Oscar Maciel Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780297283 PECOS PAC ID: 0547689861 Enrollment ID: I20201006000045 |
| Provider Name | Lidice L Nava |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508477969 PECOS PAC ID: 7113347287 Enrollment ID: I20201013000003 |
| Provider Name | Natalia Sheesley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033733555 PECOS PAC ID: 4587084546 Enrollment ID: I20201014000587 |
| Provider Name | Michelle L Barker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619506581 PECOS PAC ID: 0143640904 Enrollment ID: I20201015002377 |
| Provider Name | Kellie Jo Norris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912218116 PECOS PAC ID: 7214357607 Enrollment ID: I20201023002824 |
| Provider Name | Shereen Breuer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619577186 PECOS PAC ID: 0042620825 Enrollment ID: I20201105002666 |
| Provider Name | Sacheen King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639492531 PECOS PAC ID: 7416368790 Enrollment ID: I20201117001155 |
| Provider Name | Dormico Latashia Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841892593 PECOS PAC ID: 3375954480 Enrollment ID: I20201120002265 |
| Provider Name | Flora Issanda Stowater |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700274321 PECOS PAC ID: 2961813571 Enrollment ID: I20201202001632 |
| Provider Name | Kelly L Heffron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043895030 PECOS PAC ID: 7416365077 Enrollment ID: I20210420001124 |
| Provider Name | Miroslav Ilieff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720663644 PECOS PAC ID: 9133537632 Enrollment ID: I20210422000694 |
| Provider Name | Maria Louise Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487233094 PECOS PAC ID: 7416365812 Enrollment ID: I20210423002202 |
| Provider Name | Trisha Overvaag |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215546155 PECOS PAC ID: 1052720968 Enrollment ID: I20210505002577 |
| Provider Name | Annie Jacob |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710570601 PECOS PAC ID: 5991104275 Enrollment ID: I20210519002259 |
| Provider Name | Jennifer Woodson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073856688 PECOS PAC ID: 3678972601 Enrollment ID: I20210525001500 |
| Provider Name | Marisa A Olea |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922672344 PECOS PAC ID: 3678972320 Enrollment ID: I20210528001473 |
| Provider Name | Mercy Omijie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154928901 PECOS PAC ID: 0244630317 Enrollment ID: I20210610001846 |
| Provider Name | Leticia Maria Leon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184295115 PECOS PAC ID: 8527461268 Enrollment ID: I20210719003382 |
| Provider Name | Kimberli M Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376118919 PECOS PAC ID: 9032514831 Enrollment ID: I20210817002019 |
| Provider Name | Mark Allen Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023786225 PECOS PAC ID: 0547658775 Enrollment ID: I20211020003103 |
| Provider Name | Erin Christine Kumar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588327332 PECOS PAC ID: 6406244052 Enrollment ID: I20211101001267 |
| Provider Name | Brant R Thayer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942745161 PECOS PAC ID: 1951790146 Enrollment ID: I20211109002161 |
| Provider Name | Tiffany Brianne Kurth-mcneill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962172148 PECOS PAC ID: 9537559018 Enrollment ID: I20211125000027 |
| Provider Name | Brandon John Webster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164067922 PECOS PAC ID: 2466842737 Enrollment ID: I20211130001451 |
| Provider Name | Danielle M Klett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306516638 PECOS PAC ID: 3678963584 Enrollment ID: I20211208003153 |
| Provider Name | Julie Renee Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891450169 PECOS PAC ID: 9436540887 Enrollment ID: I20211220002131 |
| Provider Name | Jordin R Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265192983 PECOS PAC ID: 4981098845 Enrollment ID: I20220218002239 |
| Provider Name | Keith Eric Brasfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346901451 PECOS PAC ID: 0547654667 Enrollment ID: I20220304001907 |
| Provider Name | Helen E Berg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902364722 PECOS PAC ID: 9234471624 Enrollment ID: I20220414000640 |
| Provider Name | Angela Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497412977 PECOS PAC ID: 1153718515 Enrollment ID: I20220504000071 |
| Provider Name | Katelyn Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831670199 PECOS PAC ID: 4385021708 Enrollment ID: I20220524001465 |
| Provider Name | Margaret Mccane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124774005 PECOS PAC ID: 7618355033 Enrollment ID: I20220525002338 |
| Provider Name | Jessica Ashley Capps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508529421 PECOS PAC ID: 9931587391 Enrollment ID: I20220526000907 |
| Provider Name | Roxi Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942944855 PECOS PAC ID: 7416335906 Enrollment ID: I20220613001852 |
| Provider Name | Brigette Sario Kasten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366196206 PECOS PAC ID: 6103205562 Enrollment ID: I20220615002824 |
| Provider Name | Susan Carole Brenner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487315073 PECOS PAC ID: 7517346844 Enrollment ID: I20220616002404 |
| Provider Name | Vanessa Alfaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831798073 PECOS PAC ID: 4981084159 Enrollment ID: I20220706000375 |
| Provider Name | Kengne Fosso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386308864 PECOS PAC ID: 3375924269 Enrollment ID: I20220725000789 |
| Provider Name | Charles Bear Bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982347852 PECOS PAC ID: 6507248176 Enrollment ID: I20220728001677 |
| Provider Name | Shawn Todd Kebker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306339965 PECOS PAC ID: 6406238567 Enrollment ID: I20220805001453 |
| Provider Name | David Francis Marzano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710612684 PECOS PAC ID: 4284018268 Enrollment ID: I20220825002877 |
| Provider Name | Shelby Carrera Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821726175 PECOS PAC ID: 5698159887 Enrollment ID: I20220907003427 |
| Provider Name | Jennifer Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790403939 PECOS PAC ID: 7911382718 Enrollment ID: I20220914003372 |
| Provider Name | Noah Joseph Salmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558035402 PECOS PAC ID: 1153707617 Enrollment ID: I20221006001446 |
| Provider Name | Carla Spearman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396168993 PECOS PAC ID: 7416324876 Enrollment ID: I20221027003369 |
| Provider Name | Rebecca Burdi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952982134 PECOS PAC ID: 3476920901 Enrollment ID: I20221111002349 |
| Provider Name | Bradley J Zehring |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114363561 PECOS PAC ID: 9739458308 Enrollment ID: I20221121002848 |
| Provider Name | Amanda Michele Keenhold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013248699 PECOS PAC ID: 4587032149 Enrollment ID: I20221201002808 |
| Provider Name | Jesus Prado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023620473 PECOS PAC ID: 3375915630 Enrollment ID: I20230214002367 |
| Provider Name | Erin Jones-cunningham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841936143 PECOS PAC ID: 9335512037 Enrollment ID: I20230228001481 |
| Provider Name | Deziree Rodarte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194461251 PECOS PAC ID: 5890160832 Enrollment ID: I20230405001819 |
| Provider Name | Shannon D Terry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861195158 PECOS PAC ID: 7113392176 Enrollment ID: I20230405002612 |
| Provider Name | Mary Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740924679 PECOS PAC ID: 4486011434 Enrollment ID: I20230606002584 |
| Provider Name | Michelle Kathleen Iliescu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245924653 PECOS PAC ID: 0941660294 Enrollment ID: I20230718002093 |
| Provider Name | Annisha T. Wallace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346962768 PECOS PAC ID: 3375907439 Enrollment ID: I20230908000796 |
| Provider Name | Taalor Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205575156 PECOS PAC ID: 1557725223 Enrollment ID: I20230913002950 |
| Provider Name | Joy O. Ageh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144734393 PECOS PAC ID: 6002264231 Enrollment ID: I20231129001963 |
| Provider Name | Jacqueline Armstrong |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215692306 PECOS PAC ID: 3274981345 Enrollment ID: I20231129003774 |
| Provider Name | Brian Richard Evans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417583212 PECOS PAC ID: 4284084419 Enrollment ID: I20231229001062 |
| Provider Name | Mary Catherine Casciano Lovely |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457624330 PECOS PAC ID: 3971953001 Enrollment ID: I20240102001177 |
| Provider Name | Colleen C Casson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457891152 PECOS PAC ID: 8527418664 Enrollment ID: I20240102001472 |
| Provider Name | Lynda S Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851976542 PECOS PAC ID: 0446600506 Enrollment ID: I20240102002220 |
| Provider Name | Stefan Gibson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063986891 PECOS PAC ID: 1153771225 Enrollment ID: I20240102002696 |
| Provider Name | Sean Gardner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962951004 PECOS PAC ID: 8820448905 Enrollment ID: I20240102002902 |
| Provider Name | Haley Anne Biehler |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1467930305 PECOS PAC ID: 9537519533 Enrollment ID: I20240102003754 |
| Provider Name | Michielle Gatti |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1669666194 PECOS PAC ID: 2860842861 Enrollment ID: I20240102003945 |
| Provider Name | Gilberto Gutierrez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093459075 PECOS PAC ID: 8729438767 Enrollment ID: I20240103001135 |
| Provider Name | Carisa Favela |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598359937 PECOS PAC ID: 4789035585 Enrollment ID: I20240105001777 |
| Provider Name | Jessica Fiorino |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871115097 PECOS PAC ID: 8123479953 Enrollment ID: I20240105002624 |
| Provider Name | Joseph Ferral |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659908838 PECOS PAC ID: 9436500089 Enrollment ID: I20240108003978 |
| Provider Name | Erin Hammit |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053814939 PECOS PAC ID: 5890146385 Enrollment ID: I20240109003231 |
| Provider Name | Sha-kyra Alexis Jenkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881281467 PECOS PAC ID: 7911358429 Enrollment ID: I20240109004049 |
| Provider Name | Kraymer E Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851085690 PECOS PAC ID: 8921459447 Enrollment ID: I20240109004411 |
| Provider Name | Erica Harris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972924454 PECOS PAC ID: 8729439161 Enrollment ID: I20240110000384 |
| Provider Name | Ryan J. Ishikawa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316568611 PECOS PAC ID: 3577914910 Enrollment ID: I20240110000693 |
| Provider Name | Jennifer Kehrle |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1295208577 PECOS PAC ID: 8628429966 Enrollment ID: I20240110004537 |
| Provider Name | Anna R Joyce |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396295523 PECOS PAC ID: 4981055233 Enrollment ID: I20240110004935 |
| Provider Name | Tiana M. Levendusky |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1083492979 PECOS PAC ID: 7214388560 Enrollment ID: I20240110005073 |
| Provider Name | Breejia L Mcneal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306527429 PECOS PAC ID: 7012368376 Enrollment ID: I20240110005177 |
| Provider Name | Brandie Noble |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396280640 PECOS PAC ID: 1658722913 Enrollment ID: I20240110005188 |
| Provider Name | Taylor Paulino |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154064020 PECOS PAC ID: 3274984547 Enrollment ID: I20240111000350 |
| Provider Name | Christopher Lopez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841936127 PECOS PAC ID: 4587015862 Enrollment ID: I20240111000638 |
| Provider Name | Emily Kirkland Schiller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417489162 PECOS PAC ID: 1456702737 Enrollment ID: I20240111000772 |
| Provider Name | Cristina Mitchell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265175863 PECOS PAC ID: 2062863343 Enrollment ID: I20240111000895 |
| Provider Name | Anna Burnett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306583869 PECOS PAC ID: 4183075492 Enrollment ID: I20240111001982 |
| Provider Name | April Quatrine |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740933753 PECOS PAC ID: 9133570385 Enrollment ID: I20240111003891 |
| Provider Name | Sarah Sapiens |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1447759022 PECOS PAC ID: 9032560289 Enrollment ID: I20240111003932 |
| Provider Name | Mary Brownlie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073103875 PECOS PAC ID: 1456702612 Enrollment ID: I20240111004113 |
| Provider Name | Julie Seifert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003571399 PECOS PAC ID: 8022469295 Enrollment ID: I20240111004410 |
| Provider Name | Lacey Saucer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699411751 PECOS PAC ID: 3173974342 Enrollment ID: I20240111004569 |
| Provider Name | Jena Mcbride |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235850520 PECOS PAC ID: 5890146096 Enrollment ID: I20240112000405 |
| Provider Name | Kimberly Jean Wax |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528408630 PECOS PAC ID: 6406207505 Enrollment ID: I20240112000846 |
| Provider Name | Alejandra Ramirez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760004626 PECOS PAC ID: 8123479243 Enrollment ID: I20240112001544 |
| Provider Name | Sarah Serfilippi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174269237 PECOS PAC ID: 8527419670 Enrollment ID: I20240112002510 |
| Provider Name | Abby Sheahan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447870183 PECOS PAC ID: 8628420726 Enrollment ID: I20240112004283 |
| Provider Name | Lora Verley |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1174269427 PECOS PAC ID: 9436501533 Enrollment ID: I20240112004337 |
| Provider Name | Lauren Stover |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821440595 PECOS PAC ID: 9638521750 Enrollment ID: I20240113000686 |
| Provider Name | James Taylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679217566 PECOS PAC ID: 0941652093 Enrollment ID: I20240115000528 |
| Provider Name | Michelle Rose Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952922189 PECOS PAC ID: 7517319676 Enrollment ID: I20240115001053 |
| Provider Name | Charity Rae Josie Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437683059 PECOS PAC ID: 3173975240 Enrollment ID: I20240115001345 |
| Provider Name | Eric Felber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013240431 PECOS PAC ID: 5890147961 Enrollment ID: I20240115001391 |
| Provider Name | Tresha Perry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245978246 PECOS PAC ID: 4981056967 Enrollment ID: I20240115001677 |
| Provider Name | Stacy Briana Rakowitz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255957924 PECOS PAC ID: 8921450909 Enrollment ID: I20240115001799 |
| Provider Name | Matthew Wattay |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467736447 PECOS PAC ID: 1658723648 Enrollment ID: I20240116000200 |
| Provider Name | Jessica Mccallum |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881204014 PECOS PAC ID: 8921450891 Enrollment ID: I20240116002918 |
| Provider Name | Diana Belinda De La Rosa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225602923 PECOS PAC ID: 8527401678 Enrollment ID: I20240206003360 |
| Provider Name | Sabrina Solares |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003386855 PECOS PAC ID: 6901249309 Enrollment ID: I20240213000264 |
| Provider Name | Kimbralon Barnes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669942520 PECOS PAC ID: 6406290659 Enrollment ID: I20240215003911 |
| Provider Name | Amanda E. Bernal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831716083 PECOS PAC ID: 4880030162 Enrollment ID: I20240308001350 |
| Provider Name | Thuy Tran |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538805825 PECOS PAC ID: 3476990797 Enrollment ID: I20240322000777 |
| Provider Name | Kari Anna Beckstrand |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598115701 PECOS PAC ID: 6204273345 Enrollment ID: I20240325001856 |
| Provider Name | Gina Marinello-mcentire |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730826231 PECOS PAC ID: 3678910429 Enrollment ID: I20240328001388 |
| Provider Name | Katherine S Mcauley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225803026 PECOS PAC ID: 3678911476 Enrollment ID: I20240328003802 |
| Provider Name | Jeffrey Beirow |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1568105153 PECOS PAC ID: 9234577404 Enrollment ID: I20240406000355 |
| Provider Name | Brenton Wejrowski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619616554 PECOS PAC ID: 1557709607 Enrollment ID: I20240409001180 |
| Provider Name | Sharon Rae Marshall-french |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831563840 PECOS PAC ID: 9931547098 Enrollment ID: I20240409001477 |
| Provider Name | Agnes Bridgman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710613229 PECOS PAC ID: 6800235755 Enrollment ID: I20240411004311 |
| Provider Name | Lori Ann Mockler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396356952 PECOS PAC ID: 9537508205 Enrollment ID: I20240413000465 |
| Provider Name | Deshanaye K Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558007724 PECOS PAC ID: 6800235565 Enrollment ID: I20240415003572 |
| Provider Name | Elisa Rodriguez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376286948 PECOS PAC ID: 9638518863 Enrollment ID: I20240419002016 |
| Provider Name | Abigail Romero |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316682149 PECOS PAC ID: 2860831013 Enrollment ID: I20240419002911 |
| Provider Name | Christine Kuo |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1437896925 PECOS PAC ID: 3577902626 Enrollment ID: I20240422002724 |
| Provider Name | Ciara Kay |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487397089 PECOS PAC ID: 0749620581 Enrollment ID: I20240426003046 |
| Provider Name | Erica Arlene Zadakis |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1811301526 PECOS PAC ID: 3779924352 Enrollment ID: I20240514001963 |
| Provider Name | Melissa M Genco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124624788 PECOS PAC ID: 8921449547 Enrollment ID: I20240514003272 |
| Provider Name | Marie Bendy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427792407 PECOS PAC ID: 2567803869 Enrollment ID: I20240517001809 |
| Provider Name | Delfina Ceniceros |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144545021 PECOS PAC ID: 0941642193 Enrollment ID: I20240520003771 |
| Provider Name | Ryan James Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306511563 PECOS PAC ID: 1557703634 Enrollment ID: I20240521001425 |
| Provider Name | Fernanda Barragan Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023755840 PECOS PAC ID: 8527400209 Enrollment ID: I20240527000346 |
| Provider Name | Raina So |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1548813884 PECOS PAC ID: 2466994660 Enrollment ID: I20240603003573 |
| Provider Name | Aaron Moore-stovall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093443590 PECOS PAC ID: 9931641180 Enrollment ID: I20240604001303 |
Richard A. Snider, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12010 S Warner Elliot Loop, Phoenix, AZ 85044 Phone: 480-893-2644 | |
Kelly H. Roy, Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1008 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-358-8588 Fax: 602-688-6991 | |
My Family Doctor In The Valley Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd, Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
Deborah L Dykema Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20045 N 19th Ave Bldg 9-151, Phoenix, AZ 85027 Phone: 602-978-1555 | |
Scottsdale Housecall Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
Wings Of Hope Medical Services, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11022 N 28th Dr Ste 205, Phoenix, AZ 85029 Phone: 602-971-0304 Fax: 602-971-0305 | |
Sheperd Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9150 W Indian School Rd Ste 111b, Phoenix, AZ 85037 Phone: 623-247-2300 Fax: 623-247-1939 |