MEDICARE: BEHAVIORAL HEALTH SOLUTIONS, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW-O313	AZ

General Provider Information

NPI Number	:	1659311926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIORAL HEALTH SOLUTIONS, P.C.

Provider Business Mailing Address
First Line	:	3040 EAST CACTUSROAD
Second Line	:	SUITE A
City	:	PHOENIX
State	:	AZ
Zip	:	85032-7196
Country	:	US
Telephone Number	:	602-494-2363
Fax Number	:	602-494-3131

Provider Business Practice Location Address
First Line	:	3040 EAST CACTUSROAD
Second Line	:	SUITE A
City	:	PHOENIX
State	:	AZ
Zip	:	85032-7196
Country	:	US
Telephone Number	:	602-494-2363
Fax Number	:	602-494-3131

Authorized Official
Title or Position	:	CLINICAL SOCIAL WORKER
Name	:	MR. GARY L. PERSHING
Credential	:	M.S.W.
Telephone Number	:	602-494-2363

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	08/22/2020

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