| Wisteria Mental Health & Wellness Center Pllc | |
|
301 W Echo Ln Phoenix AZ 85021-5554 | |
| (480) 399-8455 | |
| (866) 845-1832 |
| Full Name | Wisteria Mental Health & Wellness Center Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 301 W Echo Ln, Phoenix, Arizona |
| Authorized Official Name and Position | Roberto Igor Bracamonte Valencia (CEO) |
| Authorized Official Contact | 6023503046 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisteria Mental Health & Wellness Center Pllc 14802 N 18th Pl Phoenix AZ 85022-3925 Ph: (480) 399-8455 | Wisteria Mental Health & Wellness Center Pllc 301 W Echo Ln Phoenix AZ 85021-5554 Ph: (480) 399-8455 |
| NPI Number | 1194413419 |
|---|---|
| Provider Enumeration Date | 04/25/2023 |
| Last Update Date | 03/14/2025 |
| Certification Date | 03/14/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194413419 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
Amra Stafford, Psyd, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 67 E Weldon Ave, Suite 320, Phoenix, AZ 85012 Phone: 602-456-7565 Fax: 602-266-0234 | |
Pro Iom Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3329 E Bell Rd Ste A2-a5, Phoenix, AZ 85032 Phone: 602-482-2282 | |
Liberty Care Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8111 N 19th Ave Apt 2038, Phoenix, AZ 85021 Phone: 602-367-7916 | |
Insight-therapy Az Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4545 E Shea Blvd Ste 235, Phoenix, AZ 85028 Phone: 602-315-4068 Fax: 602-675-2705 | |
White Tiger Integrated Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 67 E Weldon Ave Ste 220, Phoenix, AZ 85012 Phone: 603-637-7361 | |
Eden Recovery Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2538 E University Dr Ste 180, Phoenix, AZ 85034 Phone: 480-390-3375 | |
Native Country Healthcare Systems Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4805 W Thomas Rd, Phoenix, AZ 85031 Phone: 602-706-8741 |