Immanuel Behavioral Health Counseling Clinic

LBN: Immanuel Behavioral Health Counseling Clinic
Immanuel Behavioral Health Counseling Clinic is an health care organization with primary practice located at 11301 N 99Th Ave Ste 5120 , Peoria AZ 85345-5485. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Immanuel Behavioral Health Counseling Clinic can be contacted via phone (623) 876-6379, or through Pierce, Brenda Kay via phone (623) 738-8549.

Contact Information

Primary practice address
11301 N 99Th Ave Ste 5120 Peoria AZ 85345-5485
Phone: (623) 876-6379
Fax: (623) 876-6379
Website:
Map and Directions
Authorized official contact:
Name: Pierce, Brenda Kay MD MA
Phone: (623) 738-8549

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1104495084
LBN Legal business name Immanuel Behavioral Health Counseling Clinic
DBA Doing business as
Authorized official Pierce, Brenda Kay MD MA
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 23rd, 2021
Last updated Apr 27th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104495084 NPPES
Arizona MEDICAID 447591

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