CREOSOTE MENTAL HEALTH GROUP (NPI# 1811509581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811509581 |
| Entity Type | Organization |
| Organization Name | CREOSOTE MENTAL HEALTH GROUP |
| Practice Address |
4646 N Swan Rd Ste 105 Tucson AZ 85718-6715 |
| Mailing Address |
1327 E Zulema Loop Tucson AZ 85706-4415 |
| Practice Telephone | 5203076495 |
| Mailing Telephone | 5203076495 |
| Enumeration Date | 2020-08-23 |
| Last Update Date | 2020-08-23 |
| Authorized Official Name | DR. CHAD MOSHER (FOUNDER/DIRECTOR) |
| Authorized Official Telephone | 5203076495 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 172V00000X | Community Health Worker | Other Service Providers | ||
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 1053801316 | 05 | |
| AZ | GENERAL | 1053801316 | 01 |
| Street Address |
4646 N SWAN RD STE 105 |
| City | TUCSON |
| State | AZ |
| Zip Code | 85718-6715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821503103 | Janet Lee | Physical Therapist | 2720 E River Rd, Tucson, Az 85718, Tucson, AZ 85718 | 2017-12-07 |
| 1922519230 | Patricia Shumate Haebe | Naturopath | 7364 N Mountain Shadows Dr, Tucson, AZ 85718 | 2017-10-13 |
| 1831613579 | Ashley Shaw | Physician Assistant | 5856 N Placita Esplendora, Tucson, AZ 85718 | 2017-08-02 |
| 1093245680 | Genevieve Antoinette Sansonetti-sice | Advanced Practice Midwife | 7252 N Placita Sin Codicia, Tucson, AZ 85718 | 2017-06-15 |
| 1609307354 | Tucson Hacienda River, LLC | Skilled Nursing Facility | 2720 E River Road, Tucson, AZ 85718 | 2017-03-24 |
| 1629524368 | Family First Senior Services | Durable Medical Equipment & Medical Supplies | 3837 N Forest Park Dr, Unit 122, Tucson, AZ 85718 | 2016-09-01 |
| 1326410069 | Desert Edge Holdings, LLC Dba Caring Senior Service | In Home Supportive Care | 1760 E. River Road, Suite 161, Tucson, AZ 85718 | 2015-10-21 |
| 1841676616 | Manal W Sabri | Speech-Language Pathologist | 1050 E River Plaza, Suite 100, Tucson, AZ 85718 | 2015-08-04 |
| 1538569983 | Kristen Zaporowski | Physical Therapist | 1800 East River Road, Suite #200, Tucson, AZ 85718 | 2014-09-03 |
| 1598101347 | Thomas Edmund Obrien | Surgery | 5240 Circulo Sobrio, Tucson, AZ 85718 | 2013-05-21 |
| Find all providers in zip 85718 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346862265 | Cynthia Williams | Psychologist | 314 W Veterans Blvd, Tucson, AZ 85713-6026 | 2020-05-13 |
| 1942563135 | Julia Fay Padgett | Psychologist | 5116 N Calle Bujia, Tucson, AZ 85718-6166 | 2012-06-21 |
| 1700114113 | B Anne Russell | Psychologist | 6320 N La Cholla Blvd Ste 380, Tucson, AZ 85741-3828 | 2009-11-23 |
| 1811022965 | Edward Knowles Lovejoy | Psychologist | 4040 W Potvin Ln, Tucson, AZ 85742-9742 | 2007-02-22 |
| 1871694281 | Psychological and Biofeedback Services Inc | Psychologist | 4732 N Oracle Rd, Suite 316, Tucson, AZ 85705-1674 | 2006-09-26 |
| 1396795613 | Patti Rae Watson | Psychologist | 454 W Calle Lago, Tucson, AZ 85704-3914 | 2006-05-10 |
| 1417907767 | Jennifer P. Rhodes | Psychologist | 15601 N Oracle Rd, Tucson, AZ 85739-9111 | 2006-05-10 |
| 1033454541 | Richard J Brooks, Ph.d., P.C. | Psychologist | 5210 E Pima St, Suite 200, Tucson, AZ 85712-3664 | 2012-12-10 |
| 1669733143 | Glenn A Matchett-morris | Psychologist | 1224 E Lowell St, Tucson, AZ 85721-0095 | 2012-05-31 |
| 1710044664 | Michelle Lin Dorsey | Psychologist | 1224 E Lowell St, Tucson, AZ 85721-0095 | 2007-01-02 |
| Find all providers in TUCSON | ||||
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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.