| Growing a Bonsai | |
|
1934 E Camelback Rd Ste 120-513 Phoenix AZ 85016-4126 | |
| (480) 213-4463 | |
| Not Available |
| Full Name | Growing a Bonsai |
|---|---|
| Speciality | Counselor |
| Location | 1934 E Camelback Rd Ste 120-513, Phoenix, Arizona |
| Authorized Official Name and Position | Ryan a Barclay (OWNER) |
| Authorized Official Contact | 6026381658 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Growing a Bonsai 1934 E Camelback Rd # 120-513 Phoenix AZ 85016-4126 Ph: (602) 638-1658 | Growing a Bonsai 1934 E Camelback Rd Ste 120-513 Phoenix AZ 85016-4126 Ph: (480) 213-4463 |
| NPI Number | 1366038044 |
|---|---|
| Provider Enumeration Date | 12/16/2020 |
| Last Update Date | 12/04/2025 |
| Certification Date | 12/04/2025 |
| Medicare PECOS PAC ID | 5698204956 |
|---|---|
| Medicare Enrollment ID | O20250131000194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366038044 | NPI | - | NPPES |
| 1124636030 | Other | CMS-NPI (RYAN BARCLAY, LPC) | |
| 083970 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (NU) | Primary |
| Provider Name | Ryan Andrew Barclay |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124636030 PECOS PAC ID: 7315476678 Enrollment ID: I20250131000213 |
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