| Integrative Mental Health Services Llc | |
|
11811 N Tatum Blvd Ste 3031 Phoenix AZ 85028-1621 | |
| (602) 492-1706 | |
| Not Available |
| Full Name | Integrative Mental Health Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 11811 N Tatum Blvd Ste 3031, Phoenix, Arizona |
| Authorized Official Name and Position | Daniel Levi (OWNER, CLINICAL DIRECTOR) |
| Authorized Official Contact | 6024921706 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Mental Health Services Llc 11811 N Tatum Blvd Ste 3031 Phoenix AZ 85028-1621 Ph: (602) 492-1706 | Integrative Mental Health Services Llc 11811 N Tatum Blvd Ste 3031 Phoenix AZ 85028-1621 Ph: (602) 492-1706 |
| NPI Number | 1275025314 |
|---|---|
| Provider Enumeration Date | 06/05/2018 |
| Last Update Date | 12/31/2024 |
| Certification Date | 12/31/2024 |
| Medicare PECOS PAC ID | 1355789181 |
|---|---|
| Medicare Enrollment ID | O20240329000843 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275025314 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180.010511 (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Daniel Charles Levi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124579446 PECOS PAC ID: 3173961901 Enrollment ID: I20240401000630 |
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