Organization
IMMANUEL BEHAVIORAL HEALTH COUNSELING CLINIC
Active
Organization
IMMANUEL BEHAVIORAL HEALTH COUNSELING CLINIC
Active
Parent organization
15856
Organization subpart
Yes
Provider details
NPI number
Legal business name
15856
Authorized official
BRENDA KAY PIERCE MD MA (CHIEF OPERATING OFFICER)
(623) 738-8549
Entity
Organization
Contact information
Practice address
11301 N 99TH AVE STE 5120, PEORIA, AZ 85345-5485
(623) 876-6379
(623) 876-6379
Mailing address
11301 N 99TH AVE STE 5120, PEORIA, AZ 85345-5485
(623) 876-6379
(623) 876-6379
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
447591
—
AZ
Enumeration date
06/23/2021
Last updated
04/27/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up