| New Merveille Llc | |
|
2375 E Camelback Rd Ste 600 Phoenix AZ 85016-3493 | |
| (817) 707-2798 | |
| Not Available |
| Full Name | New Merveille Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2375 E Camelback Rd Ste 600, Phoenix, Arizona |
| Authorized Official Name and Position | Desire Nkomezi (OWNER) |
| Authorized Official Contact | 8177072798 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Merveille Llc 4821 N 108th Ave Phoenix AZ 85037-5471 Ph: (817) 707-2798 | New Merveille Llc 2375 E Camelback Rd Ste 600 Phoenix AZ 85016-3493 Ph: (817) 707-2798 |
| NPI Number | 1710749288 |
|---|---|
| Provider Enumeration Date | 01/29/2024 |
| Last Update Date | 03/21/2025 |
| Certification Date | 03/21/2025 |
| Medicare PECOS PAC ID | 1456797414 |
|---|---|
| Medicare Enrollment ID | O20240312004016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710749288 | NPI | - | NPPES |
| Provider Name | April R Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285224477 PECOS PAC ID: 6204212566 Enrollment ID: I20221011000119 |
| Provider Name | Danielle D Younge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649631664 PECOS PAC ID: 8820332083 Enrollment ID: I20230419002968 |
| Provider Name | Simisola Morayo Asekun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386380608 PECOS PAC ID: 9032587738 Enrollment ID: I20230512001752 |
| Provider Name | Suma Hodge |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700496718 PECOS PAC ID: 2062824162 Enrollment ID: I20240718002860 |
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