| A Wisermind Llc | |
|
20343 N Hayden Rd # 105-446 Scottsdale AZ 85255-3876 | |
| (602) 930-8462 | |
| Not Available |
| Full Name | A Wisermind Llc |
|---|---|
| Speciality | Psychologist |
| Location | 20343 N Hayden Rd # 105-446, Scottsdale, Arizona |
| Authorized Official Name and Position | Daniel E Kostelnik (VICE PRESIDENT) |
| Authorized Official Contact | 3039465003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Wisermind Llc 6000 E Evans Bldg 3 Ste 100 Denver CO 80222 Ph: (303) 951-4323 | A Wisermind Llc 20343 N Hayden Rd # 105-446 Scottsdale AZ 85255-3876 Ph: (602) 930-8462 |
| NPI Number | 1053619874 |
|---|---|
| Provider Enumeration Date | 03/02/2011 |
| Last Update Date | 10/17/2018 |
| Medicare PECOS PAC ID | 2365626017 |
|---|---|
| Medicare Enrollment ID | O20110405000643 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053619874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Robin Robert Abel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912119579 PECOS PAC ID: 6709054273 Enrollment ID: I20110728000106 |
| Provider Name | Pamela Nann Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134446800 PECOS PAC ID: 8123270428 Enrollment ID: I20121213000273 |
| Provider Name | Karen Balderrama |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841215142 PECOS PAC ID: 6608173273 Enrollment ID: I20160324002147 |
| Provider Name | Teresa A Schafer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508885146 PECOS PAC ID: 5597943134 Enrollment ID: I20160816000688 |
| Provider Name | Lindsay Werkheiser |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386894673 PECOS PAC ID: 9931383981 Enrollment ID: I20160906002051 |
| Provider Name | Jody Ortman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598214066 PECOS PAC ID: 8729368147 Enrollment ID: I20170711003164 |
| Provider Name | Crista Rene Bishop |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881715175 PECOS PAC ID: 0547675811 Enrollment ID: I20210218001406 |
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