| Tbm Mental Health Llc | |
|
17431 N 71st Dr Suite 104 Glendale AZ 85308-8598 | |
| (480) 521-6586 | |
| Not Available |
| Full Name | Tbm Mental Health Llc |
|---|---|
| Speciality | Counselor |
| Location | 17431 N 71st Dr, Glendale, Arizona |
| Authorized Official Name and Position | Timothy Miller (MBR) |
| Authorized Official Contact | 4805216586 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tbm Mental Health Llc 17431 N 71st Dr Suite 104 Glendale AZ 85308-8598 Ph: (480) 521-6586 | Tbm Mental Health Llc 17431 N 71st Dr Suite 104 Glendale AZ 85308-8598 Ph: (480) 521-6586 |
| NPI Number | 1093167108 |
|---|---|
| Provider Enumeration Date | 07/13/2016 |
| Last Update Date | 07/13/2016 |
| Medicare PECOS PAC ID | 0345522637 |
|---|---|
| Medicare Enrollment ID | O20170120002786 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093167108 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | RN1348 (Arizona) | Primary |
| Provider Name | Timothy R Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700866852 PECOS PAC ID: 0244268415 Enrollment ID: I20060110000064 |
| Provider Name | Bryan Joseph Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336500339 PECOS PAC ID: 8729378450 Enrollment ID: I20160608000563 |
| Provider Name | Daryl I Cotton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972852846 PECOS PAC ID: 4880930577 Enrollment ID: I20190117001127 |
| Provider Name | Shawn L Faust |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841762762 PECOS PAC ID: 4284966078 Enrollment ID: I20191028002889 |
| Provider Name | Brian K Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588111264 PECOS PAC ID: 8224460894 Enrollment ID: I20191120001001 |
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