| Mohave Mental Health Clinic Inc | |
|
3505 Western Ave Ste A Kingman AZ 86409-3074 | |
| (928) 757-8111 | |
| (928) 757-3256 |
| Full Name | Mohave Mental Health Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3505 Western Ave Ste A, Kingman, Arizona |
| Authorized Official Name and Position | Dawn D Abbott (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9287578111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohave Mental Health Clinic Inc 3707 N Stockton Hill Rd Ste B Kingman AZ 86409-0507 Ph: (928) 757-8111 | Mohave Mental Health Clinic Inc 3505 Western Ave Ste A Kingman AZ 86409-3074 Ph: (928) 757-8111 |
| NPI Number | 1902894272 |
|---|---|
| Provider Enumeration Date | 10/11/2005 |
| Last Update Date | 06/23/2021 |
| Medicare PECOS PAC ID | 7618963935 |
|---|---|
| Medicare Enrollment ID | O20040422000707 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902894272 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | BH2398 (Arizona) | Secondary |
| 261Q00000X | Clinic/center | OTC5896 (Arizona) | Primary |
| Provider Name | Caroline M Koch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841286820 PECOS PAC ID: 1658342860 Enrollment ID: I20040803000012 |
| Provider Name | Mohamed I Ramadan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225025984 PECOS PAC ID: 4183657034 Enrollment ID: I20050913000165 |
| Provider Name | Michael Serrano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346616174 PECOS PAC ID: 7719270255 Enrollment ID: I20160721001496 |
| Provider Name | Kelleen Stiles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437468840 PECOS PAC ID: 9638453160 Enrollment ID: I20170301002060 |
| Provider Name | Steven Korona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033432042 PECOS PAC ID: 3476724717 Enrollment ID: I20170303000985 |
| Provider Name | Mary Tulinnye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760883698 PECOS PAC ID: 6901027341 Enrollment ID: I20170316002230 |
| Provider Name | Torry Zupke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558606467 PECOS PAC ID: 5395990113 Enrollment ID: I20170317000748 |
| Provider Name | Laurence Seltzer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407867294 PECOS PAC ID: 3476617119 Enrollment ID: I20170320001022 |
| Provider Name | Deborah Radford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295802957 PECOS PAC ID: 7517029127 Enrollment ID: I20170322001443 |
| Provider Name | Min Kwon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386113926 PECOS PAC ID: 4688911225 Enrollment ID: I20190121001539 |
| Provider Name | Dana Pleshette Smith Zimmermann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457960742 PECOS PAC ID: 6204252224 Enrollment ID: I20200820001403 |
| Provider Name | Michael P Bongiorno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437475753 PECOS PAC ID: 1052724960 Enrollment ID: I20210114001799 |
| Provider Name | Abiola Omo Oyemade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417454992 PECOS PAC ID: 6507102910 Enrollment ID: I20220105000911 |
| Provider Name | Rigpa Shunya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306154133 PECOS PAC ID: 0345466074 Enrollment ID: I20220126001112 |
| Provider Name | Ejang Ngyiah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922671973 PECOS PAC ID: 0446643845 Enrollment ID: I20220208000517 |
| Provider Name | Yinka Tosho Alayande |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770283921 PECOS PAC ID: 3173986387 Enrollment ID: I20231026003870 |
J. Khan, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1739 E Beverly Ave, Suite 221, Kingman, AZ 86409 Phone: 928-681-8671 Fax: 928-681-8672 | |
North Country Healthcare, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3505 Western Ave, Kingman, AZ 86409 Phone: 928-753-1177 Fax: 928-753-1178 | |
Vital Health & Wellness Clinics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3555 Western Ave, Kingman, AZ 86409 Phone: 928-757-8440 Fax: 928-757-8448 | |
Slimming Grace Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 Johnson Ave Unit 3371, Kingman, AZ 86402 Phone: 928-279-5076 Fax: 949-695-3692 | |
Madix Medical Center, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1608 N Stockton Hill Rd Ste 101, Kingman, AZ 86401 Phone: 928-377-1984 Fax: 928-377-1983 | |
S Ismail Bokhari, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1720 E Beverly Ave, Suite B, Kingman, AZ 86409 Phone: 928-757-1333 Fax: 928-757-2367 | |
Kamyab Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2002 N Stockton Hill Rd Ste 104, Kingman, AZ 86401 Phone: 928-692-1010 Fax: 928-692-7070 |