Organization
SPECTRUM HEALTHCARE GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORINNE BAILEY (CREDENTIALING SPECIALIST)
(877) 634-7333
Entity
Organization
Contact information
Practice address
990 WILLOW CREEK RD, PRESCOTT, AZ 86301-1640
(928) 634-2236
(928) 634-8960
Mailing address
8 E COTTONWOOD ST, COTTONWOOD, AZ 86326-4382
(877) 634-7333
(866) 984-3891
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
163WP0808X
Psychiatric/Mental Health 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
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
08/09/2019
Last updated
07/21/2021
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