| Tyrae Word, | |
|
210 E Cottonwood Ln, Casa Grande, AZ 85122-2514 | |
| (520) 876-1840 | |
| (520) 421-2708 |
| Full Name | Tyrae Word |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 210 E Cottonwood Ln, Casa Grande, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598137242 | NPI | - | NPPES |
| 020018 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 15592 (Arizona) | Primary |
| Entity Name | Dos Abuelos Arizona LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720512908 PECOS PAC ID: 2860767324 Enrollment ID: O20171009003412 |
| Mailing Address | Practice Location Address |
|---|---|
| Tyrae Word, 210 E Cottonwood Ln, Casa Grande, AZ 85122-2514 Ph: (520) 876-1840 | Tyrae Word, 210 E Cottonwood Ln, Casa Grande, AZ 85122-2514 Ph: (520) 876-1840 |
Sandra A Murdock, Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 N Florence St, Casa Grande, AZ 85122 Phone: 520-836-1675 Fax: 520-836-1668 |
Deborah A Allen, LISAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 120 W Main St, Casa Grande, AZ 85222 Phone: 520-836-1675 Fax: 520-421-1969 |
Mr. Peter Anthony Picone, M.ED., LISAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 900 E Florence Blvd Ste G, Casa Grande, AZ 85122 Phone: 520-836-4278 |
Miss Cynthia D. Varnay, MC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1901 N Trekell Rd, Casa Grande, AZ 85222 Phone: 520-421-2566 Fax: 520-421-2775 |
Sara Chase, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 413 E Florence Blvd, Casa Grande, AZ 85122 Phone: 520-876-5764 Fax: 520-876-5913 |
Mary Flanery, LISAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1365 E 12th St, Casa Grande, AZ 85122 Phone: 520-371-9646 Fax: 520-466-8851 |
Mr. David Erlich, LCSW & LISAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 413 E Florence Blvd, Casa Grande, AZ 85122 Phone: 520-876-5764 Fax: 520-876-5613 |