Healthcare Provider Details

I. General information

NPI: 1356284855
Provider Name (Legal Business Name): GI ABARE KABADE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 N 24TH ST
PHOENIX AZ
85008-1004
US

IV. Provider business mailing address

2850 N 24TH ST
PHOENIX AZ
85008-1004
US

V. Phone/Fax

Practice location:
  • Phone: 602-860-7942
  • Fax:
Mailing address:
  • Phone: 602-860-7942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCSW-20736
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: