KRISTINE BRAZZEL (NPI# 1063551166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063551166 |
| Entity Type | Individual |
| Full Name | KRISTINE BRAZZEL |
| Other Name | KRISTINE SHARDY |
| Credential | PSY.D., LPC |
| Practice Address |
3707 E Southern Ave 1008 Mesa AZ 85206-2569 |
| Mailing Address |
Po Box 13051 Mesa AZ 85216-3051 |
| Practice Telephone | 4802282367 |
| Mailing Telephone | 4802282367 |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2009-06-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
LPC-2390 | AZ | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
3823 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
3707 E SOUTHERN AVE 1008 |
| City | MESA |
| State | AZ |
| Zip Code | 85206-2569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740282821 | Arizona Diabetes and Nutrition Education, LLC | Dietitian, Registered | 3707 E Southern Ave, Mesa, AZ 85206-2569 | 2005-08-10 |
| 1790384014 | Fulton and Fulton LLC | Nurse Practitioner | 3707 E Southern Ave, Mesa, AZ 85206-2569 | 2020-10-19 |
| 1235746702 | Humanity Select Home Care LLC | In Home Supportive Care | 3707 E Southern Ave, Mesa, AZ 85206-2569 | 2020-09-28 |
| 1902414782 | Danielle Young | Social Worker | 3707 E Southern Ave, Mesa, AZ 85206-2569 | 2020-07-17 |
| 1053937599 | Troy Michael Fulton | Psychiatry & Neurology | 3707 E Southern Ave, Mesa, AZ 85206-2569 | 2020-06-21 |
| 1043844632 | Aubrey Rae Laird | Counselor | 3707 E Southern Ave, Mesa, AZ 85206-2569 | 2020-02-24 |
| 1043483902 | Telfer Enterprises LLC | Home Health | 3707 E Southern Ave, Suite 1062, Mesa, AZ 85206-2569 | 2008-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
| 1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
| 1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
| 1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
| 1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
| 1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
| 1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
| 1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
| 1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
| 1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
| Find all providers in zip 85206 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518501980 | Jennifer Jones, Psy.d., LLC | Psychologist | 1930 S Alma School Rd Ste D106, Mesa, AZ 85210-3095 | 2019-10-29 |
| 1568989671 | Heal Az Counseling and Wellness Center Pllc | Psychologist | 1845 S Dobson Rd Ste 109, Mesa, AZ 85202-5662 | 2017-08-29 |
| 1417327735 | Jessica Leclerc - Oasis Psychological Services, Pllc | Psychologist | 1930 S Alma School Rd. Ste. A216, Mesa, AZ 85210 | 2015-09-29 |
| 1598194813 | Laura Mann | Psychologist | 122 N Country Club Dr, Mesa, AZ 85201-6522 | 2013-11-06 |
| 1821363730 | Steven G Fox Phd PC | Psychologist | 1845 S Dobson Rd Ste 106, Mesa, AZ 85202-5661 | 2012-03-12 |
| 1730480856 | Beverly Costantini | Psychologist | 2500 South Power Road, Bldg 9, Ste 223, Mesa, AZ 85209-6690 | 2010-11-04 |
| 1326295510 | Marilyn Stromsness | Psychologist | 2228 E Jaeger St, Mesa, AZ 85213-2933 | 2008-08-19 |
| 1891993143 | Shelly K. Woodward | Psychologist | 1845s Dobson Rd 207, Mesa, AZ 85202-5663 | 2007-07-09 |
| 1144439852 | Julio F. Angulo | Psychologist | 3039 E Irwin Ave, Mesa, AZ 85204-7271 | 2007-05-21 |
| 1982811170 | Nancy Elaine Yeamans | Psychologist | 2210 W Southern Ave, Suite B-5, Mesa, AZ 85202-4714 | 2007-05-17 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.