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Organization
SPECTRUM HEALTHCARE GROUP, INC.
Active
Organization
SPECTRUM HEALTHCARE GROUP, INC.
Active
Other names
Verde Valley Guidance Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CORINNE BAILEY (CREDENTIALING SPECIALIST)
(928) 634-2236
Entity
Organization
Contact information
Practice address
8 E COTTONWOOD ST BLDG A, COTTONWOOD, AZ 86326-6237
(877) 634-7333
(866) 984-3891
Mailing address
8 E COTTONWOOD ST, COTTONWOOD, AZ 86326-4382
(928) 634-2236
(928) 634-8960
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
163W00000X
Registered Nurse
—
—
171M00000X
Case Manager/Care Coordinator
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
BH1466
AZ
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057952
—
AZ
01
—
ZWMBQF
MEDICARE ID#
AZ
Enumeration date
11/08/2005
Last updated
09/11/2023
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