WEST YAVAPAI GUIDANCE CLINIC, INC. (NPI# 1316212178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316212178 |
| Entity Type | Organization |
| Organization Name | WEST YAVAPAI GUIDANCE CLINIC, INC. |
| Other Organization Name | WEST YAVAPAI PRIMARY CARE |
| Practice Address |
3345 N Windsong Dr Attn: Tina Tolliver, Suite B Prescott Valley AZ 86314-2283 |
| Mailing Address |
3343 N. Windsong Dr. Prescott Valley AZ 86314-2283 |
| Practice Telephone | 9285836411 |
| Practice Fax Number | 9287768031 |
| Mailing Telephone | 9284455211 |
| Mailing Fax Number | 9287768031 |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2012-12-27 |
| Authorized Official Name | PAMELA K. PIERCE (COO) |
| Authorized Official Telephone | 9284455211 |
| Is Organization Subpart | Y |
| Parent Organization Name | WEST YAVAPAI GUIDANCE CLINIC, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
OTC 5318 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | ADHS MEDICAL LICENSE | OTC 5318 | 01 |
| Other Name | Type Code |
|---|---|
| West Yavapai Primary Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073762258 | West Yavapai Guidance Clinic, Inc. | Counselor | 3347 N Windsong Dr, Prescott Valley, AZ 86314-2283 | 2008-09-12 |
| 1033163514 | West Yavapai Guidance Clinic, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 711 Hillside Ave, Prescott, AZ 86301 | 2006-05-20 |
| 1578517108 | West Yavapai Guidance Clinic, Inc. | Clinic/Center | 625 Hillside Ave, Prescott, AZ 86301 | 2006-05-19 |
| 1629618061 | West Yavapai Guidance Clinic, Inc. | Family Medicine | 625 W Hillside Ave, Prescott, AZ 86301-1936 | 2020-01-14 |
| 1639367105 | West Yavapai Guidance Clinic, Inc. | Psychiatric Hospital | 3343 N Windsong Dr, Prescott Valley, AZ 86314-1213 | 2007-10-10 |
| 1053366716 | West Yavapai Guidance Clinic, Inc. | Clinic/Center | 642 Dameron Dr, Prescott, AZ 86301-2411 | 2006-05-23 |
| 1417901943 | West Yavapai Guidance Clinic, Inc. | Clinic/Center | 3345 N Windsong Dr, Prescott Valley, AZ 86314 | 2006-05-20 |
| 1750335311 | West Yavapai Guidance Clinic, Inc. | Substance Abuse Rehabilitation Facility | 642 Dameron Dr, Prescott, AZ 86301-2411 | 2006-05-19 |
| Street Address |
3345 N WINDSONG DR ATTN: TINA TOLLIVER, SUITE B |
| City | PRESCOTT VALLEY |
| State | AZ |
| Zip Code | 86314-2283 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639169154 | Raquel Balderas | Psychiatry & Neurology | 3345 N Windsong Dr, Windsong Center, Prescott Valley, AZ 86314-2283 | 2005-10-26 |
| 1770092496 | Linda Anne Bosse | Nurse Practitioner | 3345 N Windsong Dr, Prescott Valley, AZ 86314-2283 | 2017-09-26 |
| 1215309760 | Kara Schumann | Counselor | 3345 N Windsong Dr, Prescott Valley, AZ 86314-2283 | 2015-10-23 |
| 1508237645 | Amanda Kraus | Counselor | 3345 N Windsong Dr, Prescott Valley, AZ 86314-2283 | 2015-10-15 |
| 1174916472 | Chyllia Dixon | Nurse Practitioner | 3345 N Windsong Dr, Prescott Valley, AZ 86314-2283 | 2015-03-11 |
| 1356778229 | William Couthran | Community/Behavioral Health | 3345 N Windsong Dr, Prescott Valley, AZ 86314-2283 | 2013-10-08 |
| 1164769394 | Alison A. Stambaugh | Social Worker | 3345 N Windsong Dr, Prescott Valley, AZ 86314-2283 | 2013-01-08 |
| 1568708097 | Ann M Delorme | Counselor | 3345 N Windsong Dr, Prescott Valley, AZ 86314-2283 | 2013-01-03 |
| 1871859413 | Susan Lynne Frost | Nurse Practitioner | 3345 N Windsong Dr, Prescott Valley, AZ 86314-2283 | 2012-04-09 |
| 1831419563 | Elizabeth Antoinette Haslam | Counselor | 3345 N Windsong Dr, Prescott Valley, AZ 86314-2283 | 2010-06-04 |
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| 1003398983 | Richard Telck | Pharmacist | 7720 E. Highway 69, Prescott Valley, AZ 86314 | 2018-09-06 |
| 1912493065 | Akdhc,llc | Internal Medicine | 7862 E Florentine Rd, Suite 120, Prescott Valley, AZ 86314 | 2018-07-02 |
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| 1740738046 | Janine Kauffmann | Pharmacist | 7720 East Highway 69, Prescott Valley, AZ 86314 | 2016-09-14 |
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| 1184087009 | William Beverly | Marriage & Family Therapist | 8603 E. Eastridge Dr., Ste A, Prescott Valley, AZ 86314 | 2016-03-29 |
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| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
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| 1679851455 | Cornerstone Pediatrics, P.C. | Clinic/Center | 7875 E Florentine Rd, Suite A, Prescott Valley, AZ 86314-2284 | 2011-07-28 |
| 1841343894 | Family Health Care of Prescott Valley, Inc | Clinic/Center | 8046 E Yavapai Rd, Prescott Valley, AZ 86314-8442 | 2007-01-20 |
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| City | PRESCOTT VALLEY |
| Zip Code | 86314 |
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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.