SEQUELCARE OF ARIZONA, LLC (NPI# 1376601914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376601914 |
| Entity Type | Organization |
| Organization Name | SEQUELCARE OF ARIZONA, LLC |
| Other Organization Name | PRESCOTT OPC |
| Practice Address |
3170 Stillwater Dr. Prescott AZ 86305 |
| Practice Telephone | 9287773280 |
| Practice Fax Number | 9287171660 |
| Mailing Telephone | 9287773280 |
| Mailing Fax Number | 9287171660 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2017-02-15 |
| Authorized Official Name | MRS. WENDY RAZO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9287773280 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
BH-2730 | AZ | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
BH-3517 | AZ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS ID | 157612 | 01 |
| AZ | 451604 | 05 |
| Other Name | Type Code |
|---|---|
| Prescott OPC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275860702 | Sequelcare of Arizona, LLC | Community/Behavioral Health | 450 West 5th Place, Mesa, AZ 85201 | 2009-11-04 |
| 1003060534 | Sequelcare of Arizona, LLC | Community Based Residential Treatment Facility, Mental Illness | 14410 E. Blue Ridge Road, Dewey, AZ 86327 | 2008-11-11 |
| 1063663391 | Sequelcare of Arizona, LLC | Community Based Residential Treatment Facility, Mental Illness | 3160 N. Pine View Drive, Prescott Valley, AZ 86314-2534 | 2008-10-06 |
| 1154443331 | Sequelcare of Arizona, LLC | Public Health or Welfare | 8603 E. Eastridge Drive, Ste. A, Prescott Valley, AZ 86314 | 2007-04-06 |
| 1588740930 | Sequelcare of Arizona, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 9435 E Smoki Trail, Dewey, AZ 86327-6990 | 2006-10-28 |
| 1184712143 | Sequelcare of Arizona, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 6070 N. Treadway Trail, Flagstaff, AZ 86004 | 2006-10-11 |
| 1780777540 | Sequelcare of Arizona, LLC | Community Based Residential Treatment Facility, Mental Illness | 4001 North Catherine Drive, Prescott Valley, AZ 86314 | 2006-10-02 |
| 1770676439 | Sequelcare of Arizona, LLC | Community Based Residential Treatment Facility, Mental Illness | 3240 Hualapai Mountain Road, Kingman, AZ 86401 | 2006-10-02 |
| 1124407390 | Sequelcare of Arizona, LLC | Behavioral Analyst | 8603 E Eastridge Rd, Prescott Valley, AZ 86314-8562 | 2015-05-21 |
| Street Address |
3170 STILLWATER DR. |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972005395 | Granite View Adult Care Home LLC | Assisted Living Facility | 7105 Williamson Valley Road, Prescott, AZ 86305 | 2018-03-01 |
| 1215468095 | Valerie Williams | Occupational Therapist | 926 S. Hinman Dr., Prescott, AZ 86305 | 2017-03-23 |
| 1174073837 | Caspian Gleam Medical Center LLC | Clinic/Center | 3130 Stillwater Drive, Suite B, Prescott, AZ 86305 | 2016-10-06 |
| 1114388634 | Marla Beth Perkins | Speech-Language Pathologist | 3160 Stillwater Dr., Prescott, AZ 86305 | 2016-03-10 |
| 1790159853 | Michele A. Bibeau, D.d.s. | Dentist | 1058 Fair Street, Suite A, Prescott, AZ 86305 | 2015-11-30 |
| 1609264837 | Integrative Pain Centres of Prescott | Pain Medicine | 3769 Crossings Drive, Suite B, Integrative Pain Centres of Prescott, Prescott, AZ 86305 | 2014-12-22 |
| 1649697251 | Sharon Marilyn Jackson | Counselor | 3636 Crossings Drive, Prescott, AZ 86305 | 2014-03-20 |
| 1215351259 | Stefanie Maneval | Registered Nurse | 900 Iron Springs Rd, Prescott, AZ 86305 | 2014-02-11 |
| 1508207523 | Recovery In The Pines, LLC | Community/Behavioral Health | 919 12th Place #13, Prescott, AZ 86305 | 2013-07-08 |
| 1871857359 | Neal Herbert Segovia Cabaluna | Internal Medicine | 3773 Crossings Dr Ste C, Prescott, AZ 86305 | 2012-06-28 |
| Find all providers in zip 86305 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063978781 | Terence Maguire Pilicy | Counselor | 812 Valley St Ste 7, Prescott, AZ 86305-1826 | 2019-02-18 |
| 1952875577 | Sean James Mcloughlin | Counselor | 122 N Cortez St Ste 107, Prescott, AZ 86301-3022 | 2019-01-16 |
| 1447725767 | Laura Henry Oliver | Counselor | 711 Seri Dr, Prescott, AZ 86303-7214 | 2018-10-13 |
| 1164923025 | Virginia Wenzel | Counselor | 2063 Meadowbrook Rd, Prescott, AZ 86303-5696 | 2018-02-26 |
| 1518364652 | Kathleen Hald | Counselor | 204 N Mount Vernon Ave, 112 East Merrit Street, Prescott, AZ 86301-3108 | 2014-12-03 |
| 1649697251 | Sharon Marilyn Jackson | Counselor | 3636 Crossings Drive, Prescott, AZ 86305 | 2014-03-20 |
| 1134543481 | R. Smyly Addiction Clinical Services LLC | Counselor | 819 W Gurley St Unit C, Prescott, AZ 86305-3626 | 2014-02-06 |
| 1134435019 | Penny Collins | Counselor | 332 Circle P Dr, Prescott, AZ 86303-5525 | 2010-08-30 |
| 1699089730 | Debbie Ritterbush | Counselor | 914 E Gurley St Ste 200, Prescott, AZ 86301-3245 | 2010-07-30 |
| 1093961708 | Tracey Frederiksen | Counselor | 2228 Lakewood Dr, Prescott, AZ 86301-4476 | 2008-08-13 |
| Find all providers in PRESCOTT | ||||
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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.