| Ahwatukee Psychology Llc | |
|
11011 S 48th St Ste 106 Phoenix AZ 85044-1787 | |
| (480) 223-8263 | |
| (480) 247-5705 |
| Full Name | Ahwatukee Psychology Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 11011 S 48th St Ste 106, Phoenix, Arizona |
| Authorized Official Name and Position | Mysti Rainwater (PSYCHOTHERAPIST) |
| Authorized Official Contact | 4802238263 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ahwatukee Psychology Llc 11011 S 48th St Ste 106 Phoenix AZ 85044-1787 Ph: (480) 223-8263 | Ahwatukee Psychology Llc 11011 S 48th St Ste 106 Phoenix AZ 85044-1787 Ph: (480) 223-8263 |
| NPI Number | 1326608290 |
|---|---|
| Provider Enumeration Date | 06/13/2019 |
| Last Update Date | 01/21/2025 |
| Certification Date | 01/21/2025 |
| Medicare PECOS PAC ID | 1254868441 |
|---|---|
| Medicare Enrollment ID | O20241230002852 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326608290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Mysti Rachelle Rainwater |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538377932 PECOS PAC ID: 1658802319 Enrollment ID: I20241004001725 |
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