| Fkl Enterprises, Llc | |
|
8700 E Via De Ventura Ste 280 Scottsdale AZ 85258-4541 | |
| (480) 674-9220 | |
| (480) 674-9231 |
| Full Name | Fkl Enterprises, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 8700 E Via De Ventura Ste 280, Scottsdale, Arizona |
| Authorized Official Name and Position | Filipe Coelho (OWNER) |
| Authorized Official Contact | 4806749221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fkl Enterprises, Llc 8700 E Via De Ventura Ste 280 Scottsdale AZ 85258-4541 Ph: (480) 674-9220 | Fkl Enterprises, Llc 8700 E Via De Ventura Ste 280 Scottsdale AZ 85258-4541 Ph: (480) 674-9220 |
| NPI Number | 1346982782 |
|---|---|
| Provider Enumeration Date | 04/07/2022 |
| Last Update Date | 02/18/2025 |
| Certification Date | 02/18/2025 |
| Medicare PECOS PAC ID | 2961872205 |
|---|---|
| Medicare Enrollment ID | O20230103002289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346982782 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Katherine M Crowley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215990262 PECOS PAC ID: 8820009210 Enrollment ID: I20060524000050 |
| Provider Name | David Bryan Tanis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598372807 PECOS PAC ID: 4082012547 Enrollment ID: I20211013002832 |
| Provider Name | Natalie J Andersen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346412954 PECOS PAC ID: 1658720958 Enrollment ID: I20231212002852 |
| Provider Name | Rachael Miles |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1093173494 PECOS PAC ID: 7315317658 Enrollment ID: I20240102000258 |
| Provider Name | Kai M Kline |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831762244 PECOS PAC ID: 1052762697 Enrollment ID: I20240109001029 |
| Provider Name | Jacqueline E Nash |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659019933 PECOS PAC ID: 7618329533 Enrollment ID: I20240116004530 |
| Provider Name | Carolyn Christine Dolejs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558987735 PECOS PAC ID: 0941653877 Enrollment ID: I20240126003903 |
| Provider Name | Elizabeth M Worton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053001636 PECOS PAC ID: 2860838349 Enrollment ID: I20240306003127 |
| Provider Name | Marissa Kuhl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760120901 PECOS PAC ID: 2567908197 Enrollment ID: I20240719000561 |
| Provider Name | Elyse Grace Vincent |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598593568 PECOS PAC ID: 9133669898 Enrollment ID: I20240909001896 |
| Provider Name | Aylin Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720807894 PECOS PAC ID: 5294263059 Enrollment ID: I20250108001652 |
| Provider Name | Staci Detwiler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073248357 PECOS PAC ID: 8527588235 Enrollment ID: I20250225003262 |
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