| Mind Revolution Counseling And Consulting | |
|
501 E Plaza Cir Ste B Litchfield Park AZ 85340-4917 | |
| (623) 252-0163 | |
| Not Available |
| Full Name | Mind Revolution Counseling And Consulting |
|---|---|
| Speciality | Clinic/Center |
| Location | 501 E Plaza Cir Ste B, Litchfield Park, Arizona |
| Authorized Official Name and Position | Kenni Uribe (OWNER) |
| Authorized Official Contact | 3073073007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Revolution Counseling And Consulting 16772 W Bell Rd Ste 110-449 Surprise AZ 85374-9702 Ph: (623) 252-0163 | Mind Revolution Counseling And Consulting 501 E Plaza Cir Ste B Litchfield Park AZ 85340-4917 Ph: (623) 252-0163 |
| NPI Number | 1275124711 |
|---|---|
| Provider Enumeration Date | 01/28/2021 |
| Last Update Date | 01/28/2021 |
| Certification Date | 01/28/2021 |
| Medicare PECOS PAC ID | 2466867635 |
|---|---|
| Medicare Enrollment ID | O20210222000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275124711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Rena Sabey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962876805 PECOS PAC ID: 5698043321 Enrollment ID: I20170621000523 |
| Provider Name | Kenni Uribe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699213405 PECOS PAC ID: 0244509941 Enrollment ID: I20170712002226 |
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