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General NPI Number Information
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NPI Number | 1962395442
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Entity Type | Organization
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Legal Business Name | MESA VERDE COUNSELING INC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 2585 E WILCOX DR STE A
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-2822
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Country | US
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Telephone | 520-442-2812
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Fax | 520-378-5187
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Provider Business Mailing Address
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Address Line | PO BOX 1300
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City | HEREFORD
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State | AZ
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Zip | 85615-1300
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Country | US
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Telephone | 520-442-2812
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Fax | 520-378-5187
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Authorized Official
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Title or Position | CFO
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Name | ASA RHINEHART
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Credential |
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Telephone | 520-442-0978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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