| Benson Outpatient Treatment Center | |
|
611 W Union St Benson AZ 85602-6718 | |
| (520) 586-6177 | |
| Not Available |
| Full Name | Benson Outpatient Treatment Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 611 W Union St, Benson, Arizona |
| Authorized Official Name and Position | Kathy Guzman Wells (EVP/COO) |
| Authorized Official Contact | 5208385501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Benson Outpatient Treatment Center 611 W Union St Benson AZ 85602-6718 | Benson Outpatient Treatment Center 611 W Union St Benson AZ 85602-6718 Ph: (520) 586-6177 |
| NPI Number | 1760830137 |
|---|---|
| Provider Enumeration Date | 05/26/2016 |
| Last Update Date | 05/28/2026 |
| Certification Date | 05/28/2026 |
| Medicare PECOS PAC ID | 2860488368 |
|---|---|
| Medicare Enrollment ID | O20040421000934 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760830137 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH4804 (Arizona) | Primary |
| Provider Name | John K Ekman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194722256 PECOS PAC ID: 4183695281 Enrollment ID: I20040803000744 |
| Provider Name | Debra L Ford |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376618033 PECOS PAC ID: 1658367040 Enrollment ID: I20050322000778 |
| Provider Name | Dmitry V Listengarten |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669433173 PECOS PAC ID: 4486680931 Enrollment ID: I20050715000218 |
| Provider Name | Chad Rubin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548256142 PECOS PAC ID: 5597822288 Enrollment ID: I20090325000128 |
| Provider Name | Constance L Slay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396919346 PECOS PAC ID: 5294882940 Enrollment ID: I20090415000203 |
| Provider Name | Erich R Brueschke |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265740880 PECOS PAC ID: 4981891066 Enrollment ID: I20101215000789 |
| Provider Name | Tamisha L Gant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356642920 PECOS PAC ID: 4981889458 Enrollment ID: I20110427000076 |
| Provider Name | Steven M Diez De Pinos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063502201 PECOS PAC ID: 2264699925 Enrollment ID: I20120208000066 |
| Provider Name | Rodric D Falcon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063785350 PECOS PAC ID: 9234367400 Enrollment ID: I20160323001111 |
| Provider Name | Michael D Worley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548704125 PECOS PAC ID: 4880962687 Enrollment ID: I20170620002766 |
| Provider Name | Debra a Ort |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396805412 PECOS PAC ID: 7618925298 Enrollment ID: I20170907001782 |
| Provider Name | Marie a Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619219375 PECOS PAC ID: 2668613811 Enrollment ID: I20181105002586 |
| Provider Name | Arturo D Ventura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891220257 PECOS PAC ID: 8628347846 Enrollment ID: I20210712002041 |
| Provider Name | Anton Dragonetti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972091221 PECOS PAC ID: 8224393640 Enrollment ID: I20210909003132 |
| Provider Name | Deana E Gil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477967370 PECOS PAC ID: 1557742285 Enrollment ID: I20220713000478 |
| Provider Name | Patricia Hoffman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114994050 PECOS PAC ID: 9335583624 Enrollment ID: I20240214002478 |
| Provider Name | Sandra B Kalnins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710954573 PECOS PAC ID: 3577564996 Enrollment ID: I20240418002188 |
| Provider Name | Emmanuel E Mbi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528703261 PECOS PAC ID: 9436529831 Enrollment ID: I20240605002998 |
| Provider Name | Racheal N Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811499247 PECOS PAC ID: 4385908268 Enrollment ID: I20240717004686 |
Nazcare, Inc. - B.E.S.T. Wellness Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 176 S Central Ave, Benson, AZ 85602 Phone: 928-442-9205 Fax: 602-535-3230 |
Golden Touch Aba Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 995 W 4th St, Benson, AZ 85602 Phone: 480-841-0350 |
Caring Connections for Special Needs, LLC. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 870 W 4th St, Benson, AZ 85602 Phone: 520-686-9436 |
Southeastern Arizona Behavioral Health Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 W Union St, Benson, AZ 85602 Phone: 520-586-0800 Fax: 520-586-0116 |
Caring Connections for Special Needs, LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 E 5th St, Benson, AZ 85602 Phone: 520-586-2070 Fax: 480-287-8448 |
Lazy Horse Ranch Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 714 N Madison Ave, Benson, AZ 85602 Phone: 520-826-2206 |